Organization
AWAKENED PHOENIX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY ESCOBEDO LMHC (OWNER/CLINICIAN)
(812) 244-3919
Entity
Organization
Contact information
Practice address
900 WABASH AVE, TERRE HAUTE, IN 47807-3245
(812) 244-3919
(812) 286-9183
Mailing address
27 ALLENDALE, TERRE HAUTE, IN 47802-4751
(812) 244-3919
(812) 286-9183
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/10/2025
Last updated
02/10/2025
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