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Organization
PHOENIX COUNSELING CENTER
Active
Organization
PHOENIX COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSIE HOLBROOK GREEN MSW, LCSW (CLINICIAN)
(704) 842-6333
Entity
Organization
Contact information
Practice address
2505 COURT DR, GASTONIA, NC 28054-2140
(704) 842-6333
(704) 854-4860
Mailing address
2505 COURT DR, GASTONIA, NC 28054-2140
(704) 842-6333
(704) 854-4860
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P004885
NC
Other
Enumeration date
10/05/2010
Last updated
04/28/2011
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