| The Phoenix Counseling Center | |
|
1200 W Apache St Farmington NM 87401-3886 | |
| (505) 258-2763 | |
| (505) 675-2803 |
| Full Name | The Phoenix Counseling Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1200 W Apache St, Farmington, New Mexico |
| Authorized Official Name and Position | Kimberly Ann Haynie (OWNER) |
| Authorized Official Contact | 5052582763 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Phoenix Counseling Center 1200 W Apache St Farmington NM 87401-3886 Ph: (505) 258-2763 | The Phoenix Counseling Center 1200 W Apache St Farmington NM 87401-3886 Ph: (505) 258-2763 |
| NPI Number | 1124735485 |
|---|---|
| Provider Enumeration Date | 11/04/2022 |
| Last Update Date | 11/01/2023 |
| Certification Date | 01/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124735485 | NPI | - | NPPES |
| 32255705 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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