Organization
THE PHOENIX CLINIC NFP
Active
Other names
Phoenix Clinic Chicago
Organization subpart
No
Provider details
NPI number
Authorized official
TAYLOR ARIEL PETTWAY LMFT (EXECUTIVE DIRECTOR)
(773) 431-7397
Entity
Organization
Contact information
Practice address
1136 S DELANO CT W STE B201, CHICAGO, IL 60605-3734
(773) 431-7397
Mailing address
2436 W CULLOM AVE, CHICAGO, IL 60618-1604
(773) 431-7397
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/11/2023
Last updated
04/11/2023
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