MEDICARE: R.I.S.E. COUNSELING & CONSULTING SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1811692916
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R.I.S.E. COUNSELING & CONSULTING SERVICES, LLC

Provider Business Mailing Address
First Line	:	1801 HIGH ST
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23704-3105
Country	:	US
Telephone Number	:
Fax Number	:	757-335-4759

Provider Business Practice Location Address
First Line	:	1801 HIGH ST
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23704-3105
Country	:	US
Telephone Number	:	757-381-6987
Fax Number	:	757-335-4759

Authorized Official
Title or Position	:	OWNER
Name	:	EBONY WRIGHT
Credential	:	LPC
Telephone Number	:	757-381-6987

Provider Enumeration Date	:	03/30/2023
Last Update Date	:	03/30/2023

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