Provider Demographics
NPI:1710748215
Name:RISE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:RISE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:LAURAN
Authorized Official - Last Name:KOELKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC-C, NCC, CADC
Authorized Official - Phone:207-494-5457
Mailing Address - Street 1:2 ROTHENBURG PLATZ
Mailing Address - Street 2:
Mailing Address - City:NORTH BERWICK
Mailing Address - State:ME
Mailing Address - Zip Code:03906-6172
Mailing Address - Country:US
Mailing Address - Phone:207-494-5457
Mailing Address - Fax:
Practice Address - Street 1:2 ROTHENBURG PLATZ
Practice Address - Street 2:
Practice Address - City:NORTH BERWICK
Practice Address - State:ME
Practice Address - Zip Code:03906-6172
Practice Address - Country:US
Practice Address - Phone:207-494-5457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty