Phoenix Rising Therapeutic Services Lcsw Pc - Medicare Mental Health Clinic in Alfred Station, NY

Phoenix Rising Therapeutic Services Lcsw Pc is a medicare enrolled mental health clinic (Social Worker - Clinical) in Alfred Station, New York. The current practice location for Phoenix Rising Therapeutic Services Lcsw Pc is 5295 E Valley Rd, Alfred Station, New York. For appointments, you can reach them via phone at (607) 587-8260. The mailing address for Phoenix Rising Therapeutic Services Lcsw Pc is 5295 E Valley Rd, Alfred Station, New York and phone number is (607) 587-8260.

Phoenix Rising Therapeutic Services Lcsw Pc is licensed to practice in New York (license number R045595-1). The clinic also participates in the medicare program and its NPI number is 1003295395. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (607) 587-8260.

Contact Information

Phoenix Rising Therapeutic Services Lcsw Pc
5295 E Valley Rd
Alfred Station
NY 14803-9715
(607) 587-8260
Not Available

Mental Health Clinic Profile

Full NamePhoenix Rising Therapeutic Services Lcsw Pc
SpecialitySocial Worker
Location5295 E Valley Rd, Alfred Station, New York
Authorized Official Name and PositionMary Beth Mcdonough (SOLE OWNER)
Authorized Official Contact6075878260
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Phoenix Rising Therapeutic Services Lcsw Pc
5295 E Valley Rd
Alfred Station
NY 14803-9715

Ph: (607) 587-8260
Phoenix Rising Therapeutic Services Lcsw Pc
5295 E Valley Rd
Alfred Station
NY 14803-9715

Ph: (607) 587-8260

NPI Details:

NPI Number1003295395
Provider Enumeration Date05/20/2015
Last Update Date05/20/2015

Medicare PECOS Information:

Medicare PECOS PAC ID2961794144
Medicare Enrollment IDO20160708000261

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Medical Identifiers

Medical identifiers for Phoenix Rising Therapeutic Services Lcsw Pc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003295395NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical R045595-1 (New York)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Phoenix Rising Therapeutic Services Lcsw Pc acts as a billing entity for following providers:
Provider NameMary Beth Mcdonough
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1265442495
PECOS PAC ID: 3375550817
Enrollment ID: I20060308000704

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Social Worker in Alfred Station, NY


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