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Organization
PHOENIX COUNSELING CENTER
Active
Organization
PHOENIX COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN PAUL OLIVER M.A., MPA (DIRECTOR)
(704) 491-0829
Entity
Organization
Contact information
Practice address
322 MCBEE ST, LINCOLNTON, NC 28092-2819
(704) 240-9453
(704) 240-4603
Mailing address
839 MAJESTIC CT STE 1, GASTONIA, NC 28054-5152
(704) 396-6747
(704) 671-2553
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
MHL-036-214
NC
101YM0800X
Mental Health Counselor
—
NC
251B00000X
Case Management Agency
MHL 036-214
NC
251S00000X
Community/Behavioral Health Agency
Primary
MHL 036-214
NC
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
MHL-036-214
NC
324500000X
Substance Abuse Rehabilitation Facility
MHL-036-214
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005727
—
NC
05
—
8301469
—
NC
05
—
8301469B
—
NC
05
—
8301469G
—
NC
05
—
8301469P
—
NC
05
—
8301469Q
—
NC
Enumeration date
09/23/2006
Last updated
02/09/2021
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