1578021929 NPI number — RISE COUNSELING INC

Table of content: (NPI 1578021929)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578021929 NPI number — RISE COUNSELING INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RISE COUNSELING INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1578021929
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/05/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
103 E BEAVER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STATE COLLEGE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16801-4969
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-409-7744
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 E BEAVER AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STATE COLLEGE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16801-4969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-409-7744
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2019

Additional Information

Authorized Official

Authorized Official Last Name:
BILLS
Authorized Official First Name:
TESSA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/OUTPATIENT THERAPIST
Authorized Official Telephone Number:
814-330-8828

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1346663705 . This is a "HIGHMARK BC BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "UHS STUDENT RESOURCES" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "PENN BEH. HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "PHCS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "MAGELLEN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "FIRST HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "MHNNET" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "COVENTRY CARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "MHN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1346663705 . This is a "MULTI PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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