Organization
PHOENIX FAMILY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNTH JASON PRYOR LMHP (EXECUTIVE DIRECTOR)
(804) 986-1121
Entity
Organization
Contact information
Practice address
5206 MARKEL RD STE 301, RICHMOND, VA 23230-3044
(804) 505-4737
(804) 505-5179
Mailing address
5206 MARKEL RD STE 301, RICHMOND, VA 23230-3044
(180) 450-5473
(804) 505-4737
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407329857
—
VA
05
—
1699326710
—
VA
Enumeration date
09/20/2019
Last updated
07/24/2023
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