NPIMap

Organization Active NPI

The Phoenix Recovery Center LLC

Doing business as The Phoenix Counseling Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • South Jordan, UT
National Provider Identifier
1992125553
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
5549 Issued in UT
Legal business name
THE PHOENIX RECOVERY CENTER LLC
Doing business as
The Phoenix Counseling Center
Practice address
489 W. South Jordan Parkway
Ste 400
South Jordan, UT 84095
Phone
(801) 438-3185
Fax
(801) 438-3184
NPI assigned
Apr 22, 2014
Last updated
Apr 5, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
THE PHOENIX RECOVERY CENTER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Authorized official

Name
Kristin Timmons
Title
Executive Director
Phone
(801) 438-3185

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101Y00000X 5549 UT
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 5549 UT
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 5549 UT
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 5549 UT
Behavior AnalystGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103K00000X 5549 UT
Adult Mental Health Clinic/Center 261QM0850X 5549 UT
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 5549 UT Primary

Addresses

Primary practice location

489 W. South Jordan Parkway
Ste 400
South Jordan, UT 84095

Mailing address

9980 S 300 W Ste 105
Sandy, UT 84070-3641
Phone (801) 438-3185

Other practice location 1

11762 S State St
Suite 360
Draper, UT 84020-7155
Phone (801) 571-6798 ext. 201

Other practice location 2

9980 S 300 W Ste 105
Sandy, UT 84070-3641
Phone (801) 438-3185

Other names 1

  • The Phoenix Counseling Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Phoenix Recovery Counseling Center - Riverdale8 organizations share this tax ID, including this one
Part of
The Phoenix Recovery Counseling Center - Riverdale

Other organizations with this tax ID 7

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

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1398124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1992125553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9980 S 300 W STE 105",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840703641",
            "telephone_number": "801-438-3185",
            "fax_number": "801-438-3184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 W. SOUTH JORDAN PARKWAY",
            "address_2": "STE 400",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "801-438-3185",
            "fax_number": "801-438-3184"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11762 S State St",
            "address_2": "Suite 360",
            "address_purpose": "LOCATION",
            "city": "Draper",
            "state": "UT",
            "postal_code": "840207155",
            "country_code": "US",
            "telephone_number": "801-571-6798 x201",
            "fax_number": "801-619-2016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9980 S 300 W Ste 105",
            "address_purpose": "LOCATION",
            "city": "Sandy",
            "state": "UT",
            "postal_code": "840703641",
            "country_code": "US",
            "telephone_number": "801-438-3185",
            "fax_number": "801-438-3184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE PHOENIX RECOVERY CENTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE PHOENIX RECOVERY CENTER, LLC",
        "enumeration_date": "2014-04-22",
        "last_updated": "2021-04-05",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "TIMMONS",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-438-3185"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor",
            "state": "UT",
            "license": "5549",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "UT",
            "license": "5549",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "5549",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "UT",
            "license": "5549",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": "UT",
            "license": "5549",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "UT",
            "license": "5549",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "UT",
            "license": "5549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Phoenix Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Phoenix Counseling Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.