Phoenix Ascension Counseling Llc | |
106 E 4th St Ste A O Fallon IL 62269-2104 | |
(847) 340-1922 | |
Not Available |
Full Name | Phoenix Ascension Counseling Llc |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 106 E 4th St Ste A, O Fallon, Illinois |
Authorized Official Name and Position | Candyce Jupiter (OWNER) |
Authorized Official Contact | 8473401922 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Phoenix Ascension Counseling Llc 106 E 4th St Ste A O Fallon IL 62269-2104 Ph: () - | Phoenix Ascension Counseling Llc 106 E 4th St Ste A O Fallon IL 62269-2104 Ph: (847) 340-1922 |
NPI Number | 1912611245 |
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Provider Enumeration Date | 01/11/2023 |
Last Update Date | 01/11/2023 |
Certification Date | 01/11/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1912611245 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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