Healthcare Provider Details

I. General information

NPI: 1346191194
Provider Name (Legal Business Name): ARISE WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2026
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 FRAZER DR
MIDDLETOWN OH
45042-3937
US

IV. Provider business mailing address

123 FRAZER DR
MIDDLETOWN OH
45042-3937
US

V. Phone/Fax

Practice location:
  • Phone: 231-571-0819
  • Fax:
Mailing address:
  • Phone: 231-571-0819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: KAITLYN OLSEN
Title or Position: FOUNDER/OWNER
Credential: MSW, LISW
Phone: 231-571-0819