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General NPI Number Information
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NPI Number | 1023614161
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Entity Type | Organization
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Legal Business Name | ARISE WELLNESS, PLLC
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Dates
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Enumeration Date | 12/04/2020
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 7545 CENTURION PKWY STE 104
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City | JACKSONVILLE
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State | FL
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Zip | 32256-4118
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Country | US
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Telephone | 904-452-5027
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Fax | 904-253-3492
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Provider Business Mailing Address
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Address Line | 7643 GATE PKWY STE 104-1197
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City | JACKSONVILLE
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State | FL
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Zip | 32256-2893
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Country | US
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Telephone | 904-802-2571
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Fax |
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Authorized Official
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Title or Position | CEO, FOUNDER
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Name | KORMASAH CURTIS
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Credential | LMFT
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Telephone | 904-802-2571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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