Phoenix Counseling And Wellness, LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Moline, IL. Organization (NPI-2).
NPI number1851914816
StatusActive
Last updated in NPPESMay 26, 2020
Details
- NPI
- 1851914816
- Entity type
- Organization (NPI-2)
- Legal business name
- Phoenix Counseling And Wellness, LLC
- Organization subpart
- No
- Enumeration date
- May 26, 2020
- Certification date
- May 26, 2020
- Last updated
- May 26, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – |
Practice location
604 35th AveMoline, IL 61265-6174
Phone 309-363-2060
Mailing address
53 Longview DrGeneseo, IL 61254-9111
Phone 309-363-2060
Authorized official
L Michelle Howlett
Lead Therapist/Owner
3093632060
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