Provider Demographics
NPI:1710743455
Name:RISE COUNSELING SERVICES LCSW, PLLC
Entity Type:Organization
Organization Name:RISE COUNSELING SERVICES LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:347-761-1169
Mailing Address - Street 1:165 LINWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11208-1134
Mailing Address - Country:US
Mailing Address - Phone:347-761-1169
Mailing Address - Fax:
Practice Address - Street 1:165 LINWOOD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-1134
Practice Address - Country:US
Practice Address - Phone:347-761-1169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty