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Organization
PHOENIX HEALTH PROFESSIONAL GROUP, LLC
Active
Organization
PHOENIX HEALTH PROFESSIONAL GROUP, LLC
Active
Other names
Phoenix Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOEL K GOLOSKIE (COUNSEL)
(617) 771-1154
Entity
Organization
Contact information
Practice address
99 WAYLAND AVE STE 100, PROVIDENCE, RI 02906-4314
(617) 771-1154
Mailing address
1301 ATWOOD AVE STE 100, JOHNSTON, RI 02919-4933
(617) 771-1154
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
—
—
104100000X
Social Worker
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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