Healthcare Provider Details

I. General information

NPI: 1437088937
Provider Name (Legal Business Name): RISE THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7307 BALTIMORE AVE STE 109
COLLEGE PARK MD
20740-3231
US

IV. Provider business mailing address

3004 12TH ST NE
WASHINGTON DC
20017-2408
US

V. Phone/Fax

Practice location:
  • Phone: 202-365-5517
  • Fax:
Mailing address:
  • Phone: 202-365-5517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: JUSTIN SYBENGA
Title or Position: OWNER
Credential: LCSW-C
Phone: 202-365-5517