# PHOENIX COUNSELING CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902074768
- **Authorized official:** MR. KEVIN PAUL OLIVER MA, MPA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (704) 491-0829

## Contact information

- **Practice address:** 510 S ASPEN ST, LINCOLNTON, NC 28092-2735
- **Practice address phone:** (704) 735-7719
- **Practice address fax:** (704) 921-3066
- **Mailing address:** 631 BRAWLEY SCHOOL RD, SUITE 200B, PMB 301, MOORESVILLE, NC 28117-6204
- **Mailing address phone:** (704) 360-4531
- **Mailing address fax:** (704) 360-2544

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NC | Yes |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 251B00000X | Case Management Agency | — | NC | — |
| 251S00000X | Community/Behavioral Health Agency | — | NC | — |

## Other

- **Enumeration date:** 02/14/2008
- **Last updated:** 03/17/2018