Organization
THE PHOENIX CLINIC NFP
Active
Parent organization
THE PHOENIX CLINIC NFP
Other names
Phoenix Clinic Chicago
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE PHOENIX CLINIC NFP
Authorized official
TAYLOR ARIEL PETTWAY LMFT (EXECUTIVE DIRECTOR)
(773) 431-7397
Entity
Organization
Contact information
Practice address
917 W 18TH ST STE 325, CHICAGO, IL 60608-2400
(773) 431-7397
Mailing address
4955 S CALUMET AVE APT 4S, CHICAGO, IL 60615-2275
(773) 431-7397
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
04/15/2025
Last updated
12/16/2025
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