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General NPI Number Information
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NPI Number | 1538924857
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Entity Type | Organization
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Legal Business Name | CELESTIAL HOPE RISING SERVICES VA, LLC
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Dates
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Enumeration Date | 02/15/2024
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Last Update Date | 02/15/2024
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Provider Practice Location Address
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Address Line | 4445 CORPORATION LN STE 264
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-3671
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Country | US
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Telephone | 301-323-8437
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 WILLOUGHBY RD
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City | PARKVILLE
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State | MD
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Zip | 21234-4832
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Country | US
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Telephone | 301-602-3925
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KI'ASHA SHANTEL SANDERS
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Credential | LCSW-C, LGSW
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Telephone | 301-602-3925
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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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Taxonomy #2
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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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