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Organization
PHOENIX SOCIAL WORK CENTER, INC.
Active
Organization
PHOENIX SOCIAL WORK CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN W BLANKS III (EXECUTIVE DIRECTOR)
(260) 424-0411
Entity
Organization
Contact information
Practice address
2200 LAKE AVE STE 240, FORT WAYNE, IN 46805-5397
(260) 424-0411
(260) 424-3530
Mailing address
2200 LAKE AVE STE 240, FORT WAYNE, IN 46805-5397
(260) 424-0411
(260) 424-3530
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
NULL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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