Healthcare Provider Details

I. General information

NPI: 1225822679
Provider Name (Legal Business Name): RISE UP COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3243 W EVERGREEN AVE UNIT G
CHICAGO IL
60651-3176
US

IV. Provider business mailing address

3243 W EVERGREEN AVE UNIT G
CHICAGO IL
60651-3176
US

V. Phone/Fax

Practice location:
  • Phone: 308-870-4018
  • Fax:
Mailing address:
  • Phone: 308-870-4018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MEGAN WARREN
Title or Position: OWNER
Credential: LCPC
Phone: 708-955-5609