| Rising Phoenix Counseling L.c. | |
|
1471 Dewar Dr Ste 216 Rock Springs WY 82901-5826 | |
| (307) 382-0743 | |
| (844) 861-9507 |
| Full Name | Rising Phoenix Counseling L.c. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1471 Dewar Dr Ste 216, Rock Springs, Wyoming |
| Authorized Official Name and Position | Tiffani Jean Beatty (DIRECTOR/OWNER) |
| Authorized Official Contact | 3073820743 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rising Phoenix Counseling L.c. 1471 Dewar Dr Ste 216 Rock Springs WY 82901-5826 Ph: (307) 382-0743 | Rising Phoenix Counseling L.c. 1471 Dewar Dr Ste 216 Rock Springs WY 82901-5826 Ph: (307) 382-0743 |
| NPI Number | 1093303349 |
|---|---|
| Provider Enumeration Date | 01/04/2021 |
| Last Update Date | 02/09/2021 |
| Certification Date | 02/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093303349 | NPI | - | NPPES |
| 144270800 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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