Organization
PHOENIX PROJECT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEN STEVENS LPCC (OWNER)
(270) 218-3968
Entity
Organization
Contact information
Practice address
415 N DIXIE HWY, CAVE CITY, KY 42127-9517
(606) 341-0834
Mailing address
735 LEVI BEAMS RD, MAGNOLIA, KY 42757-7909
(270) 218-3968
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
175T00000X
Peer Specialist
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/13/2023
Last updated
04/28/2024
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