Organization
PHOENIX COUNSELING AND SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JESSICA LEIGH HALSTEAD MSW, LGSW (DIRECTOR)
(304) 806-2273
Entity
Organization
Contact information
Practice address
4855 MACCORKLE AVE SW STE 200, SOUTH CHARLESTON, WV 25309-1331
(304) 806-2273
Mailing address
4855 MACCORKLE AVE SW STE 200, SOUTH CHARLESTON, WV 25309-1331
(304) 806-2273
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
16-121
WV
104100000X
Social Worker
BP00942576
WV
Other
Enumeration date
11/20/2017
Last updated
11/20/2017
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