Healthcare Provider Details

I. General information

NPI: 1003571738
Provider Name (Legal Business Name): RISING SUN THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 MAIN ST
HARLEYSVILLE PA
19438-2501
US

IV. Provider business mailing address

417 ALEXANDRA DR
EAGLEVILLE PA
19403-1301
US

V. Phone/Fax

Practice location:
  • Phone: 484-925-3349
  • Fax: 215-392-8540
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LEAH ANDREONI
Title or Position: THERAPIST/OWNER
Credential: LMFT
Phone: 267-221-9415