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General NPI Number Information
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NPI Number | 1760947824
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Entity Type | Organization
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Legal Business Name | RISE COUNSELING LLC
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Dates
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Enumeration Date | 02/04/2019
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Last Update Date | 02/04/2019
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Provider Practice Location Address
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Address Line | 284 RACEBROOK RD STE 218
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City | ORANGE
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State | CT
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Zip | 06477-3103
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Country | US
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Telephone | 914-462-9403
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Fax |
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Provider Business Mailing Address
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Address Line | 284 RACEBROOK RD STE 218
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City | ORANGE
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State | CT
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Zip | 06477-3103
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Country | US
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Telephone | 914-462-9403
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | ERIC VINGO
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Credential | LADC, LMSW
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Telephone | 914-462-9403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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