Provider Demographics
NPI:1124455928
Name:PHOENIX COUNSELING AND CONSULTING, LLC
Entity type:Organization
Organization Name:PHOENIX COUNSELING AND CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRELLWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, PIP, C-CATODSW
Authorized Official - Phone:205-240-5460
Mailing Address - Street 1:3 OFFICE PARK CIR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2510
Mailing Address - Country:US
Mailing Address - Phone:205-240-5460
Mailing Address - Fax:
Practice Address - Street 1:3 OFFICE PARK CIR
Practice Address - Street 2:SUITE 230
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2510
Practice Address - Country:US
Practice Address - Phone:205-240-5460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-11
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1943C251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health