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PHOENIX RECOVERY, LLC
NPI 1861053183
Counselor - Addiction (Substance Use Disorder) in Bridgeport, CT

Active since June 26, 2019
4270 MAIN ST STE 200, BRIDGEPORT, CT 06606(203) 243-6170 Get Directions Write a Review

NPPES record last updated: June 26, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Phoenix Recovery, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHOENIX RECOVERY, LLC (NPI 1861053183) is a healthcare organization registered as an addiction (substance use disorder) in Bridgeport, Connecticut and active in the NPI registry since June 2019. The organization lists Amond Kenyutta Tillman, Substance Abuse Therapist, as its authorized official.

NPPES Registry Identity

NPI1861053183
Entity TypeOrganization
Primary Taxonomy101YA0400X
Legal Business NamePHOENIX RECOVERY, LLC
Location Address4270 MAIN ST STE 200Bridgeport, CT 06606-2306
Mailing Address14 Marie Dr Apt 12Seymour, CT 06483-3665 · (203) 243-6170
Phone(203) 243-6170
Organization SubpartNo
Authorized OfficialAmond Kenyutta TillmanSubstance Abuse Therapist · (203) 243-6170
Enumeration DateJune 26, 2019
✔ NPI 1861053183 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
4270 MAIN ST STE 200, Bridgeport, CT 06606
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Other Identifiers 1

Medicaid008087099CT

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THE PEOPLE'S CHOICE ADVOCATES OF CT LLC
Case Manager/Care Coordinator
4270 MAIN ST STE 200
BRIDGEPORT, CT 06606
Greater Bridgeport Planning Region (203) 612-4839

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phoenix Recovery, LLC's NPI number?

The NPI number for Phoenix Recovery, LLC is 1861053183. It was assigned to this organization in the NPPES registry on June 26, 2019.

Where is Phoenix Recovery, LLC located?

Phoenix Recovery, LLC is located at 4270 Main St Ste 200, Bridgeport, CT 06606. The listed phone number is (203) 243-6170.

What is Phoenix Recovery, LLC's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Phoenix Recovery, LLC was last updated on June 26, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.