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General NPI Number Information
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NPI Number | 1811588932
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Entity Type | Organization
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Legal Business Name | PHOENIX RISING COUNSELING AND CONSULTING, LLC.
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Dates
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Enumeration Date | 02/01/2021
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 8609 WESTWOOD CENTER DR STE 110
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City | TYSONS CORNER
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State | VA
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Zip | 22182-7525
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Country | US
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Telephone | 571-581-9299
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Fax |
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Provider Business Mailing Address
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Address Line | 18039 RED MULBERRY RD
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City | DUMFRIES
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State | VA
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Zip | 22026-2967
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Country | US
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Telephone | 571-241-7485
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | KIA WILSON
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Credential |
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Telephone | 571-581-9299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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