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General NPI Number Information
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NPI Number | 1104423185
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Entity Type | Organization
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Legal Business Name | RISING PHOENIX COUNSELING SOLUTIONS
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Dates
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Enumeration Date | 10/03/2020
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Last Update Date | 12/11/2020
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Provider Practice Location Address
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Address Line | 210 N HIGGINS AVE STE 222
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City | MISSOULA
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State | MT
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Zip | 59802-4443
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Country | US
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Telephone | 406-249-6437
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Fax |
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Provider Business Mailing Address
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Address Line | 210 N HIGGINS AVE STE 222
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City | MISSOULA
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State | MT
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Zip | 59802-4443
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Country | US
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Telephone | 406-249-6437
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PROFESSIONAL COUN
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Name | SHANNON RAE MCNABB
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Credential | LCPC, MHPP
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Telephone | 406-249-6437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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