Healthcare Provider Details

I. General information

NPI: 1992623342
Provider Name (Legal Business Name): AURORA RISING THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 S PORTLAND DR
LITTLE EGG HARBOR TWP NJ
08087-1213
US

IV. Provider business mailing address

4 S PORTLAND DR
LITTLE EGG HARBOR TWP NJ
08087-1213
US

V. Phone/Fax

Practice location:
  • Phone: 267-301-5072
  • Fax:
Mailing address:
  • Phone: 267-301-5072
  • 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: NICOLE KAREN EDELMAN
Title or Position: MENTAL HEALTH THERAPIST
Credential: LCSW
Phone: 267-301-5072