Provider Information for 1548843121
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
CICELY CALVARESI-HOLSTON LPC
Other Names:Professional Name:PHOENIX WELLNESS LLC DBS CICELY HOLSTON COUNSELINGSex: Female
NPI: 1548843121
Last Updated: 2024-12-30
Certification Date: 2024-12-30
Certification Date: 2024-12-30
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1548843121 | ||||||||||||||||
| Enumeration Date | 2021-05-03 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 1209 WHITFIELD BLVD READING, PA 19609-1138 United States Phone: 484-222-8282 | Fax: | ||||||||||||||||
| Primary Practice Address | 2 WOODLAND RD LOWR LEVEL WYOMISSING, PA 19610-1999 United States Phone: 484-222-8282 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | |||||||||||||||||
| Health Information Exchange |
| ||||||||||||||||
| Other Identifiers |
| ||||||||||||||||
| Taxonomy |
|