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Organization

PHOENIX HEALTH PROFESSIONAL GROUP, LLC

Active
Other names
Phoenix Health
Organization subpart
No

Provider details

NPI number
Authorized official
JOEL K GOLOSKIE (COUNSEL)
(617) 771-1154
Entity
Organization

Contact information

Practice address
99 WAYLAND AVE STE 100, PROVIDENCE, RI 02906-4314
(617) 771-1154
Mailing address
1301 ATWOOD AVE STE 100, JOHNSTON, RI 02919-4933
(617) 771-1154

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
104100000X
Social Worker
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse

Other

Enumeration date
06/11/2020
Last updated
06/11/2020
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