Provider Demographics
NPI:1154915668
Name:PHOENIX COUNSELING LLC
Entity type:Organization
Organization Name:PHOENIX COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:STURDIVANT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:205-249-0887
Mailing Address - Street 1:3807 WEATHERSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-1622
Mailing Address - Country:US
Mailing Address - Phone:205-461-8552
Mailing Address - Fax:
Practice Address - Street 1:500 SOUTHLAND DR. STE 232
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226
Practice Address - Country:US
Practice Address - Phone:205-461-8552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL3497OtherALABAMA BOARD OF EXAMINER OF COUNSELING