Healthcare Provider Details
I. General information
NPI: 1578021929
Provider Name (Legal Business Name): RISE COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2019
Last Update Date: 03/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
103 E BEAVER AVE
STATE COLLEGE PA
16801-4969
US
IV. Provider business mailing address
103 E BEAVER AVE
STATE COLLEGE PA
16801-4969
US
V. Phone/Fax
- Phone: 814-409-7744
- Fax:
- Phone: 814-409-7744
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | HIGHMARK BC BS |
| # 2 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | UPMC |
| # 3 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | AETNA |
| # 4 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | |
| Identifier Issuer | BLUE CROSS BLUE SHIELD |
| # 5 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | UHS STUDENT RESOURCES |
| # 6 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | PENN BEH. HEALTH |
| # 7 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | PHCS |
| # 8 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | MAGELLEN |
| # 9 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | FIRST HEALTH |
| # 10 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | MHNNET |
| # 11 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | CIGNA |
| # 12 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | COVENTRY CARE |
| # 13 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | CAPITAL BLUE CROSS |
| # 14 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | MHN |
| # 15 | |
| Identifier | 1346663705 |
| Identifier Type | OTHER |
| Identifier State | PA |
| Identifier Issuer | MULTI PLAN |
VIII. Authorized Official
Name:
TESSA
BILLS
Title or Position: OWNER/OUTPATIENT THERAPIST
Credential: LSW
Phone: 814-330-8828
