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General NPI Number Information
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NPI Number | 1366120701
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Entity Type | Organization
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Legal Business Name | PHOENIX RISING SOLUTIONS
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Dates
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Enumeration Date | 07/06/2023
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Last Update Date | 07/06/2023
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Provider Practice Location Address
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Address Line | 1400 MAIN ST UNIT 114
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City | CLARKSVILLE
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State | IN
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Zip | 47129-3109
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Country | US
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Telephone | 502-224-8561
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 MAIN ST UNIT 114
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City | CLARKSVILLE
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State | IN
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Zip | 47129-3109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHARON STRAUB
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Credential | LCSW-C
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Telephone | 502-224-8651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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