Organization
PHOENIX ASSOCIATES COUNSELING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J CUDMORE (DIRECTOR OF DEVELOPMENT)
(817) 338-0311
Entity
Organization
Contact information
Practice address
801 ROAD TO SIX FLAGS W STE 132, ARLINGTON, TX 76012-2600
(817) 795-3030
(817) 795-3099
Mailing address
3001 W 5TH ST, SUITE A, FORT WORTH, TX 76107-8900
(817) 338-0311
(817) 332-9075
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1656-3039
TX
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
1656-3039
TX
261QM1300X
Multi-Specialty Clinic/Center
1656-3039
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212971001
—
TX
Enumeration date
10/03/2012
Last updated
07/21/2022
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