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General NPI Number Information
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NPI Number | 1548870850
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Entity Type | Organization
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Legal Business Name | ARISE THERAPY, PLLC
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Dates
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Enumeration Date | 08/03/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 1449 N CALIFORNIA AVE APT 1R
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City | CHICAGO
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State | IL
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Zip | 60622-1653
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Country | US
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Telephone | 312-566-8258
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Fax | 872-231-2389
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Provider Business Mailing Address
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Address Line | PO BOX 14265
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City | CHICAGO
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State | IL
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Zip | 60614-8503
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Country | US
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Telephone | 312-566-8258
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Fax | 872-231-2389
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | ANNA N VALIANOS
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Credential | LCSW
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Telephone | 312-566-8258
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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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