Healthcare Provider Details

I. General information

NPI: 1124917109
Provider Name (Legal Business Name): RISE THERAPEUTIC SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2025
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

918 ELIZABETH AVE
ELIZABETH NJ
07201-3309
US

IV. Provider business mailing address

59 ELLINGTON ST APT 1
EAST ORANGE NJ
07017-5754
US

V. Phone/Fax

Practice location:
  • Phone: 973-380-9766
  • Fax: 973-360-8654
Mailing address:
  • Phone: 973-380-4954
  • 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 Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: STACY-ANN D LAMBERT
Title or Position: DIRECTOR
Credential: LCSW
Phone: 973-380-4954