Provider Demographics
NPI:1255579983
Name:PHASES, LLC
Entity type:Organization
Organization Name:PHASES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:HELENA
Authorized Official - Middle Name:F
Authorized Official - Last Name:ROLDAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, CADC
Authorized Official - Phone:251-478-5050
Mailing Address - Street 1:601 BEL AIR BLVD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36606-3513
Mailing Address - Country:US
Mailing Address - Phone:251-478-5050
Mailing Address - Fax:251-478-5015
Practice Address - Street 1:601 BEL AIR BLVD
Practice Address - Street 2:SUITE 404
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-3513
Practice Address - Country:US
Practice Address - Phone:251-478-5050
Practice Address - Fax:251-478-5015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0832101YA0400X
AL2085101YP2500X
AL628101YP2500X
AL163106H00000X
AL1352101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty