NPIMap

Organization Active NPI

Phoenix Associates Counseling Services, Inc.

  • Community/Behavioral Health Agency
  • Fort Worth, TX
National Provider Identifier
1982836250
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1656-A Issued in TX
Legal business name
PHOENIX ASSOCIATES COUNSELING SERVICES, INC.
Practice address
3001-A W 5TH Street
Fort Worth, TX 76107-2200
Phone
(817) 338-0311
Fax
(817) 332-9075
NPI assigned
Aug 20, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Cudmore
Title
Director of Development
Phone
(817) 338-0311

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1656-A TX Primary
Adult Mental Health Clinic/Center 261QM0850X
Multi-Specialty Clinic/Center 261QM1300X 1656-A TX

Addresses

Primary practice location

3001-A W 5TH Street
Fort Worth, TX 76107-2200

Mailing address

3001-A W 5TH Street
Fort Worth, TX 76107-2200
Phone (817) 338-0311

Other identifiers 1

IdentifierTypeStateIssuer
212971001MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Associates Counseling Services Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3001 W 5th St
#A
Fort Worth, TX 76107
Phone (817) 338-0311

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1982836250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001-A W 5TH STREET",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072200",
            "telephone_number": "817-338-0311",
            "fax_number": "817-332-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001-A W 5TH STREET",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761072200",
            "telephone_number": "817-338-0311",
            "fax_number": "817-332-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX ASSOCIATES COUNSELING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "CUDMORE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR OF DEVELOPMENT",
        "authorized_official_telephone_number": "817-338-0311"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TX",
            "license": "1656-A",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "TX",
            "license": "1656-A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212971001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.