Organization
PHOENIX COUNSELING CENTER
Active
Parent organization
PHOENIX COUNSELING CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX COUNSELING CENTER
Authorized official
MR. KEVIN PAUL OLIVER MA, MPA (EXECUTIVE DIRECTOR)
(704) 921-3070
Entity
Organization
Contact information
Practice address
804 N LAFAYETTE ST STE 2, SHELBY, NC 28150-3898
(704) 476-4106
Mailing address
839 MAJESTIC CT STE 1, GASTONIA, NC 28054-5152
(704) 396-6747
(704) 854-4860
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NC
101YM0800X
Mental Health Counselor
—
NC
251B00000X
Case Management Agency
—
NC
251S00000X
Community/Behavioral Health Agency
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831377563
NPI
NC
05
—
1831377563
—
NC
Enumeration date
02/05/2008
Last updated
07/21/2022
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