Organization
PHOENIX COUNSELING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM 'MIMS' GORDON M.ED., LPC (OWNER, THERAPIST)
(865) 548-7474
Entity
Organization
Contact information
Practice address
729 CHARLES SEIVERS, CLINTON, TN 37716
(865) 548-7474
(865) 494-9819
Mailing address
PO BOX 567, NORRIS, TN 37828-0567
(865) 548-7474
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
298
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5441087
—
TN
Enumeration date
02/02/2007
Last updated
08/22/2020
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