Healthcare Provider Details

I. General information

NPI: 1932688348
Provider Name (Legal Business Name): RISE COUNSELING AND WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2018
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W MAIN ST
TRINITY TX
75862-7586
US

IV. Provider business mailing address

521 E HOUSTON ST
LOVELADY TX
75851-2409
US

V. Phone/Fax

Practice location:
  • Phone: 936-642-0061
  • Fax: 936-715-3345
Mailing address:
  • Phone: 936-642-0061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number73906
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number73906
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number73906
License Number StateTX
# 7
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number77316
License Number StateTX

VIII. Authorized Official

Name: MRS. KATHLEEN MCMAHON
Title or Position: DIRECTOR
Credential: MA, LPC, NCC
Phone: 936-577-0592