Provider Demographics
NPI:1710945225
Name:PAGE, RISE HANNAH (LCPC, LMHC, CCDC, NC)
Entity Type:Individual
Prefix:MS
First Name:RISE
Middle Name:HANNAH
Last Name:PAGE
Suffix:
Gender:F
Credentials:LCPC, LMHC, CCDC, NC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 HALPINE RD APT 1384
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-7626
Mailing Address - Country:US
Mailing Address - Phone:407-970-0084
Mailing Address - Fax:240-833-3451
Practice Address - Street 1:206 N ADAMS ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1829
Practice Address - Country:US
Practice Address - Phone:407-970-0084
Practice Address - Fax:240-833-3451
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP1599101YA0400X
FLMH6477101YM0800X
FLMH6447101YM0800X
MDLC7662101YM0800X
MDC4302101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL767428700Medicaid