PHOENIX GROUP HOME (NPI# 1336654854) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336654854 |
| Entity Type | Organization |
| Organization Name | PHOENIX GROUP HOME |
| Other Organization Name | PHOENIX MENTAL HEALTH |
| Practice Address |
303 Offnere St Portsmouth OH 45662-4655 |
| Practice Telephone | 7408769369 |
| Practice Fax Number | 7408769213 |
| Mailing Telephone | 7408769369 |
| Mailing Fax Number | 7408769213 |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |
| Authorized Official Name | LAURA TARR (CEO) |
| Authorized Official Telephone | 6065858985 |
| Is Organization Subpart | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 01-7588 | OH | Agencies |
| Other Name | Type Code |
|---|---|
| Phoenix Mental Health | Doing Business As Name - Organization |
| Street Address |
303 OFFNERE ST |
| City | PORTSMOUTH |
| State | OH |
| Zip Code | 45662-4655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588144414 | Carrie Burchett | Case Manager/Care Coordinator | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-08-20 |
| 1457839375 | Tristin Fay Jenkins | Registered Nurse | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-08-02 |
| 1750868121 | Sue Carol Lehman | Social Worker | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-07-27 |
| 1841777463 | Carlena Smith | Case Manager/Care Coordinator | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-07-26 |
| 1891271052 | Devin Allen Spurgeon | Case Management | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-07-11 |
| 1962997932 | Jordan Lee Kennard | Case Manager/Care Coordinator | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-06-22 |
| 1427542901 | Bryant Christopher Jamison | Case Manager/Care Coordinator | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-06-19 |
| 1063906543 | Michael Green | Case Manager/Care Coordinator | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-06-19 |
| 1336632223 | Danette S Dyke | Registered Nurse | 303 Offnere St, Portsmouth, OH 45662-4655 | 2018-06-14 |
| 1265921563 | Anthony J.l Galyon | Counselor | 303 Offnere St, Portsmouth, OH 45662 | 2018-05-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528613346 | Stacia N Boyer | Nurse Practitioner | 1611 27th Street, Fulton Bldg Suite 101, Portsmouth, OH 45662 | 2019-08-08 |
| 1487210167 | Rose Speier | Registered Nurse | 920 Gallia Street, Portsmouth, OH 45662 | 2019-05-17 |
| 1083123491 | Megan Rhea | Case Manager/Care Coordinator | 901 Wahington St, Portsmouth, OH 45662 | 2017-09-28 |
| 1376061903 | Alanna Lee Reisinger | Physical Therapist | 522 Glenwood Ave., New Boston, OH 45662 | 2017-09-04 |
| 1871010967 | Nicole Lynne Johnson | Counselor | 800 Gallia Street Suite 600, Portsmouth, OH 45662 | 2017-08-29 |
| 1629595822 | William Zachary Nance | Counselor | 800 Gallia Street, Suite 600, Portsmouth, OH 45662 | 2017-08-28 |
| 1962929703 | Melissa Rodbell | Speech-Language Pathologist | 514 Union St., Portsmouth, OH 45662 | 2017-08-23 |
| 1346604626 | Todd Davis | Counselor | 2954 Walnut St., Portsmouth, OH 45662 | 2016-04-12 |
| 1083078406 | Gordon Sanders | Counselor | 2954 Walnut Street, Portsmouth, OH 45662 | 2016-04-12 |
| 1033573910 | Michael L Purdy | Nurse Practitioner | 1735 27th Street Waller Bldg Suite 302, Portsmouth, OH 45662 | 2016-04-07 |
| Find all providers in zip 45662 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619574837 | Seacoast Pathways | Community/Behavioral Health | 155 Brewery Ln Ste 102, Portsmouth, NH 03801-4995 | 2020-10-01 |
| 1710599873 | Tinas Love and Care Inc | Community/Behavioral Health | 165 Choate St, Portsmouth, VA 23707-4567 | 2020-08-20 |
| 1508488305 | Island Light Psychotherapy, LLC | Community/Behavioral Health | 11 King Charles Dr Ste A, Portsmouth, RI 02871-1364 | 2020-05-14 |
| 1164918496 | Camp Loud and Services | Community/Behavioral Health | 3280 Academy Ave, Portsmouth, VA 23703-3203 | 2018-07-10 |
| 1790208296 | Stepless Ladders LLC | Community/Behavioral Health | 1521 Wilcox Ave, Portsmouth, VA 23704-6814 | 2017-07-18 |
| 1033641006 | Shellie Lindbergh Rankin Jr. | Community/Behavioral Health | 1402 Newby Rd, Portsmouth, VA 23701-3130 | 2017-03-29 |
| 1760832505 | Granite Pathways | Community/Behavioral Health | 865 Islington St, Portsmouth, NH 03801-4229 | 2016-06-13 |
| 1003265109 | Synergy Health Systems | Community/Behavioral Health | 1602 Cavalier Blvd, Portsmouth, VA 23701-3808 | 2016-06-09 |
| 1033571005 | Connecting Communities, LLC | Community/Behavioral Health | 309 County St Ste 203, Portsmouth, VA 23704-3701 | 2016-03-28 |
| 1215323274 | D'vine Intervention Counseling Center | Community/Behavioral Health | 2424 Oak Street, Portsmouth, VA 27870 | 2015-04-07 |
| Find all providers in PORTSMOUTH | ||||
| City | PORTSMOUTH |
| Zip Code | 45662 |
Please comment or provide details below to improve the information on PHOENIX GROUP HOME.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.