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General NPI Number Information
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NPI Number | 1164350930
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Entity Type | Organization
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Legal Business Name | RISE AND SHINE THERAPY LLC
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Dates
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Enumeration Date | 05/12/2026
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 3720 TULAROSA DR
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City | LAFAYETTE
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State | IN
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Zip | 47905-4058
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Country | US
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Telephone | 765-233-2001
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Fax |
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Provider Business Mailing Address
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Address Line | 4315 COMMERCE DR. SUITE 440 PMB 194
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City | LAFAYETTE
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State | IN
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Zip | 47905-0458
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Country | US
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Telephone | 765-233-2001
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | TIEFA NICHOLE HERNANDEZ
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Credential | MSW, LCSW
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Telephone | 765-233-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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