Healthcare Provider Details

I. General information

NPI: 1902736762
Provider Name (Legal Business Name): RISE ABOVE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 E BROAD ST
HAZLETON PA
18201-5657
US

IV. Provider business mailing address

30 S 15TH ST STE 1550
PHILADELPHIA PA
19102-4806
US

V. Phone/Fax

Practice location:
  • Phone: 570-266-2155
  • Fax:
Mailing address:
  • Phone: 570-266-2155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: LAURA J JACOBY
Title or Position: LPC
Credential: LPC
Phone: 570-266-2155