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General NPI Number Information
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NPI Number | 1639600240
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Entity Type | Organization
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Legal Business Name | RISE COUNSELING SERVICES
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 03/24/2017
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Provider Practice Location Address
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Address Line | 4545 CLAWSON TANK DR SUITE 222
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City | CLARKSTON
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State | MI
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Zip | 48346-2581
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Country | US
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Telephone | 248-972-7889
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Fax |
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Provider Business Mailing Address
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Address Line | 4545 CLAWSON TANK DR SUITE 222
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City | CLARKSTON
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State | MI
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Zip | 48346-2581
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Country | US
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Telephone | 248-972-7889
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MEGAN MCCLAIN
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Credential |
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Telephone | 248-972-7889
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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 | 6801063313
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License Number State | MI
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