| Phoenix Counseling, Ltd | |
|
1500 West Main Street Suite 300 Sun Prairie WI 53590 | |
| (608) 825-6711 | |
| (608) 834-6499 |
| Full Name | Phoenix Counseling, Ltd |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1500 West Main Street, Sun Prairie, Wisconsin |
| Authorized Official Name and Position | David A Kuykendall (DIRECTOR) |
| Authorized Official Contact | 6088256711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Counseling, Ltd 1500 West Main St. Suite 300 Sun Prairie WI 53590 Ph: (608) 825-6711 | Phoenix Counseling, Ltd 1500 West Main Street Suite 300 Sun Prairie WI 53590 Ph: (608) 825-6711 |
| NPI Number | 1235263427 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 09/04/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235263427 | NPI | - | NPPES |
| 42226100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 621 (Wisconsin) | Primary |
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