| Amy's Rising Phoenix Counseling, Pllc | |
|
3225 Battleground Ave Ste 4 Greensboro NC 27408-2636 | |
| (336) 265-2720 | |
| (336) 265-2721 |
| Full Name | Amy's Rising Phoenix Counseling, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3225 Battleground Ave Ste 4, Greensboro, North Carolina |
| Authorized Official Name and Position | Amy Leigh O'hearn (OWNER) |
| Authorized Official Contact | 3362652720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy's Rising Phoenix Counseling, Pllc 2710 Chadbury Dr Greensboro NC 27407-6697 Ph: (336) 987-4449 | Amy's Rising Phoenix Counseling, Pllc 3225 Battleground Ave Ste 4 Greensboro NC 27408-2636 Ph: (336) 265-2720 |
| NPI Number | 1245068907 |
|---|---|
| Provider Enumeration Date | 07/24/2024 |
| Last Update Date | 07/24/2024 |
| Certification Date | 07/24/2024 |
| Medicare PECOS PAC ID | 2264971159 |
|---|---|
| Medicare Enrollment ID | O20240822003797 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245068907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Amy Leigh O'hearn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669197976 PECOS PAC ID: 3173062064 Enrollment ID: I20240822004002 |
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