PHOENIX PLACE NPI 1740065713

NPI Information

NPI: 1740065713
Provider Name: PHOENIX PLACE
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
CLIA Number: 18D2308485
Address: 2012 W CHESTNUT ST
LOUISVILLE, KY
ZIP 40203
Phone: (502) 656-9261

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NPI Details

PHOENIX PLACE is a community behavioral health in Louisville, KY. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, 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. PHOENIX PLACE NPI is 1740065713. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2012 W CHESTNUT ST
LOUISVILLE, KY
ZIP 40203-542
Phone: (502) 656-9261

The provider's authorized official is Diamond Calloway .
The authorized official title is Executive Director and has the following contact phone number (502) 656-9261.

The CLIA number assigned to this NPI record is 18D2308485 - other - behavioral health organiz with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/29/2023 and was last updated on 5/7/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	No
2	101YM0800X	Counselor	Mental Health	No
3	251B00000X	Case Management		No
4	251S00000X	Community/Behavioral Health		Yes
5	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
6	3245S0500X	Substance Abuse Rehabilitation Facility	Substance Abuse Treatment, Children	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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