Provider Demographics
NPI:1083380737
Name:ARISE RENEWED COUNSELING, LLC
Entity Type:Organization
Organization Name:ARISE RENEWED COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAKEIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRODIE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:470-367-2817
Mailing Address - Street 1:5161 BROOK HOLLOW PKWY STE 224
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-3652
Mailing Address - Country:US
Mailing Address - Phone:470-261-1392
Mailing Address - Fax:470-422-7511
Practice Address - Street 1:5161 BROOK HOLLOW PKWY STE 224
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-3652
Practice Address - Country:US
Practice Address - Phone:470-261-1392
Practice Address - Fax:470-422-7511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty