| Phoenix Counseling Services, Inc. | |
|
1820 Central Ave Ste D Hot Springs AR 71901-6898 | |
| (501) 463-4627 | |
| (501) 463-4629 |
| Full Name | Phoenix Counseling Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1820 Central Ave Ste D, Hot Springs, Arkansas |
| Authorized Official Name and Position | Tracy Terwilliger (CEO) |
| Authorized Official Contact | 5014634627 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Counseling Services, Inc. 1820 Central Ave Ste D Hot Springs AR 71901-6898 Ph: (501) 463-4627 | Phoenix Counseling Services, Inc. 1820 Central Ave Ste D Hot Springs AR 71901-6898 Ph: (501) 463-4627 |
| NPI Number | 1326690595 |
|---|---|
| Provider Enumeration Date | 07/09/2019 |
| Last Update Date | 01/05/2021 |
| Certification Date | 01/05/2021 |
| Medicare PECOS PAC ID | 7315370103 |
|---|---|
| Medicare Enrollment ID | O20191209002903 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326690595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Carol A Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124159306 PECOS PAC ID: 6901971217 Enrollment ID: I20080821000331 |
| Provider Name | Tad C Tillemans |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346459765 PECOS PAC ID: 3072676246 Enrollment ID: I20090114000317 |
| Provider Name | Lisa D Kilcrease |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053439836 PECOS PAC ID: 7214126010 Enrollment ID: I20110110000577 |
| Provider Name | Sharlyn Ann Woody |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962475517 PECOS PAC ID: 8325220874 Enrollment ID: I20110304000655 |
| Provider Name | Rebecca Lynn Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982031514 PECOS PAC ID: 7416266069 Enrollment ID: I20151021001548 |
| Provider Name | Donna Brister |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548311442 PECOS PAC ID: 3072892884 Enrollment ID: I20161118001953 |
| Provider Name | Charl Y Buxton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790933513 PECOS PAC ID: 8123181542 Enrollment ID: I20190306001020 |
| Provider Name | Ashley Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063054955 PECOS PAC ID: 8022444249 Enrollment ID: I20200207000204 |
| Provider Name | Brittney Lee Shanek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306476676 PECOS PAC ID: 3375970221 Enrollment ID: I20200305001439 |
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