Healthcare Provider Details

I. General information

NPI: 1225913890
Provider Name (Legal Business Name): HOUSE OF THE RISING PHOENIX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2836 AMELIA ST
NEW ORLEANS LA
70115-6804
US

IV. Provider business mailing address

8735 DUNWOODY PL # 10399
ATLANTA GA
30350-2995
US

V. Phone/Fax

Practice location:
  • Phone: 504-358-0978
  • Fax: 504-226-5513
Mailing address:
  • Phone: 504-358-0978
  • Fax: 504-226-5513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER JONES
Title or Position: OWNER
Credential: LPC
Phone: 504-358-0978