Healthcare Provider Details

I. General information

NPI: 1831033323
Provider Name (Legal Business Name): RISING UP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 MAIN ST STE B4
BUZZARDS BAY MA
02532-3251
US

IV. Provider business mailing address

258 MAIN ST STE B4
BUZZARDS BAY MA
02532-3251
US

V. Phone/Fax

Practice location:
  • Phone: 508-388-5833
  • Fax: 508-452-6328
Mailing address:
  • Phone: 508-388-5833
  • Fax: 508-452-6328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LEIGH-ANN LARSON
Title or Position: CEO
Credential: LMHC
Phone: 508-207-0071