Healthcare Provider Details

I. General information

NPI: 1659031094
Provider Name (Legal Business Name): RISE COUNSELING & CONSULTING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2021
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 E MAIN ST
ANAMOSA IA
52205-5701
US

IV. Provider business mailing address

213 E MAIN ST
ANAMOSA IA
52205-5701
US

V. Phone/Fax

Practice location:
  • Phone: 319-224-0722
  • Fax: 877-728-2951
Mailing address:
  • Phone: 319-224-0722
  • Fax: 877-728-2951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 6
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MELISSA ANN PAULSEN OBERBRECKLING
Title or Position: OWNER
Credential: MA, LMFT, RPT-S
Phone: 319-224-0722