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General NPI Number Information
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NPI Number | 1003791880
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Entity Type | Organization
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Legal Business Name | PHOENIX RISING J2R LLC
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Dates
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Enumeration Date | 08/09/2025
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Last Update Date | 08/09/2025
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Provider Practice Location Address
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Address Line | 320 SOUTH ST APT 10L
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6060
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Country | US
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Telephone | 973-727-2402
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Fax |
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Provider Business Mailing Address
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Address Line | 320 SOUTH ST APT 10L
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6060
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Country | US
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Telephone | 973-727-2402
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Fax |
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Authorized Official
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Title or Position | PROFESSIONAL COUNSELOR
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Name | RIMA PATEL
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Credential | LPC, LCADC
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Telephone | 973-727-2402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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