Provider Demographics
NPI:1306211560
Name:ARISE COUNSELING AND WELLNESS PLLC.
Entity Type:Organization
Organization Name:ARISE COUNSELING AND WELLNESS PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CALDERON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:512-766-3579
Mailing Address - Street 1:109 ENTERPRISE PKWY STE 203
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-8636
Mailing Address - Country:US
Mailing Address - Phone:512-766-3579
Mailing Address - Fax:
Practice Address - Street 1:109 ENTERPRISE PKWY STE 203
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-8636
Practice Address - Country:US
Practice Address - Phone:512-766-3579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65759101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX344671805Medicaid