Provider Demographics
NPI:1508378951
Name:ARISE COUNSELING AND CONSULTING CENTER
Entity Type:Organization
Organization Name:ARISE COUNSELING AND CONSULTING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:T
Authorized Official - Last Name:HINES
Authorized Official - Suffix:SR
Authorized Official - Credentials:LPCA
Authorized Official - Phone:571-330-2829
Mailing Address - Street 1:6055 ST PETERS CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:CONOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28613-8752
Mailing Address - Country:US
Mailing Address - Phone:571-330-2829
Mailing Address - Fax:
Practice Address - Street 1:6055 ST PETERS CHURCH RD
Practice Address - Street 2:
Practice Address - City:CONOVER
Practice Address - State:NC
Practice Address - Zip Code:28613-8752
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13289251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health