Provider Demographics
NPI:1144839408
Name:PHOENIX COUNSELING AND RESOURCES, LLC
Entity type:Organization
Organization Name:PHOENIX COUNSELING AND RESOURCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELYSIA
Authorized Official - Middle Name:GABRIEL
Authorized Official - Last Name:ERGLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:256-712-5665
Mailing Address - Street 1:121 EDGEWOOD DR UNIT 3349
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-0966
Mailing Address - Country:US
Mailing Address - Phone:256-762-4890
Mailing Address - Fax:205-430-2771
Practice Address - Street 1:1128 BRADSHAW DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-1438
Practice Address - Country:US
Practice Address - Phone:256-712-5665
Practice Address - Fax:256-712-5665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health