Organization
PHOENIX ASSOCIATES COUNSELING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID CUDMORE (DIRECTOR OF DEVELOPMENT)
(817) 338-0311
Entity
Organization
Contact information
Practice address
3001-A W 5TH STREET, FORT WORTH, TX 76107-2200
(817) 338-0311
(817) 332-9075
Mailing address
3001-A W 5TH STREET, FORT WORTH, TX 76107-2200
(817) 338-0311
(817) 332-9075
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1656-A
TX
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
1656-A
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
212971001
—
TX
Enumeration date
08/20/2009
Last updated
10/19/2021
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