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General NPI Number Information
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NPI Number | 1841182920
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Entity Type | Organization
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Legal Business Name | RISE LIFE ENRICHMENT AND CONSULTING SERVICES LLC
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 4931 DEMPSEY DR
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City | CHARLESTON
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State | WV
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Zip | 25313-2001
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Country | US
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Telephone | 304-451-5759
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Fax |
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Provider Business Mailing Address
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Address Line | 110 MAIN ST
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City | BECKLEY
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State | WV
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Zip | 25801-4611
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Country | US
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Telephone | 304-451-5759
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Fax |
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Authorized Official
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Title or Position | OWNER/LICSW
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Name | MICHAEL STARR
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Credential |
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Telephone | 847-305-4866
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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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