| Phoenix Therapy Llc | |
|
422 Highland Avenue Building C Suite 1 Cheshire CT 06410-2526 | |
| (800) 820-8210 | |
| Not Available |
| Full Name | Phoenix Therapy Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 422 Highland Avenue, Cheshire, Connecticut |
| Authorized Official Name and Position | Crystal Shanatai Mitchell-brivett (MANAGING MEMBER) |
| Authorized Official Contact | 2038984265 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Therapy Llc 31 Hawthorne Ave Derby Ct CT 06418-1101 Ph: (800) 820-8210 | Phoenix Therapy Llc 422 Highland Avenue Building C Suite 1 Cheshire CT 06410-2526 Ph: (800) 820-8210 |
| NPI Number | 1053168393 |
|---|---|
| Provider Enumeration Date | 05/03/2024 |
| Last Update Date | 05/03/2024 |
| Certification Date | 05/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053168393 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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