Provider Demographics
NPI:1871033225
Name:RISE UP COUNSELING & CONSULTING PLLC
Entity Type:Organization
Organization Name:RISE UP COUNSELING & CONSULTING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAKEENA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:SPELLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, LCAS
Authorized Official - Phone:980-621-4395
Mailing Address - Street 1:700 N CANNON BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-3798
Mailing Address - Country:US
Mailing Address - Phone:980-621-4395
Mailing Address - Fax:704-731-7178
Practice Address - Street 1:700 N CANNON BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-3798
Practice Address - Country:US
Practice Address - Phone:980-621-4395
Practice Address - Fax:704-731-7178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-05
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1952735169Medicaid