Healthcare Provider Details

I. General information

NPI: 1760310528
Provider Name (Legal Business Name): SOL RISE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 3RD AVE SE STE 206-02
ROCHESTER MN
55904-4619
US

IV. Provider business mailing address

300 3RD AVE SE STE 206-02
ROCHESTER MN
55904-4619
US

V. Phone/Fax

Practice location:
  • Phone: 507-906-0348
  • Fax: 507-322-1702
Mailing address:
  • Phone: 507-906-0348
  • Fax: 507-322-1702

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: JAZMIN PORTILLO
Title or Position: PSYCHOTHERAPIST
Credential: LICSW
Phone: 507-908-0348