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General NPI Number Information
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NPI Number | 1629854880
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Entity Type | Organization
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Legal Business Name | RISING SUN COUNSELING LLC
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 10/27/2024
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Provider Practice Location Address
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Address Line | 1550 N MILFORD RD STE 101B
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City | MILFORD
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State | MI
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Zip | 48381-1058
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Country | US
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Telephone | 248-462-6530
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Fax | 248-694-0917
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Provider Business Mailing Address
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Address Line | 1550 N MILFORD RD STE 101B
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City | MILFORD
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State | MI
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Zip | 48381-1058
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Country | US
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Telephone | 248-462-6530
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Fax | 248-694-0917
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Authorized Official
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Title or Position | OWNER
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Name | MR. JORDAN RAY
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Credential | LPC
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Telephone | 248-462-6530
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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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