Provider Demographics
NPI:1093382574
Name:ARISE PSYCHOLOGICAL WELLNESS AND CONSULTING, PLLC
Entity Type:Organization
Organization Name:ARISE PSYCHOLOGICAL WELLNESS AND CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER & MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:P
Authorized Official - Last Name:WYATT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-803-6981
Mailing Address - Street 1:PO BOX 821
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-0821
Mailing Address - Country:US
Mailing Address - Phone:919-627-7057
Mailing Address - Fax:
Practice Address - Street 1:401 PROVIDENCE RD STE 200
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2203
Practice Address - Country:US
Practice Address - Phone:919-627-7057
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-04
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty