# PHOENIX COUNSELING OF GASTON LINCOLN AND CLEVELAND

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Phoenix Counseling Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568621001
- **Authorized official:** MR. KEVIN P OLIVER MA MPA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (704) 921-3070

## Contact information

- **Practice address:** 2505 COURT DR, GASTONIA, NC 28054-2140
- **Practice address phone:** (704) 921-3070
- **Practice address fax:** (704) 921-3066
- **Mailing address:** 4007 WILD NURSERY CT, CHARLOTTE, NC 28215-5345
- **Mailing address phone:** (704) 921-3070
- **Mailing address fax:** (703) 921-3966

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NC | — |
| 101YM0800X | Mental Health Counselor | — | NC | — |
| 251S00000X | Community/Behavioral Health Agency | — | NC | Yes |

## Other

- **Enumeration date:** 06/09/2008
- **Last updated:** 06/09/2008