Provider Demographics
NPI:1942939459
Name:RISE WELLNESS GROUP
Entity Type:Organization
Organization Name:RISE WELLNESS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILPIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:713-446-7698
Mailing Address - Street 1:8431 KATY FWY STE 101
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1946
Mailing Address - Country:US
Mailing Address - Phone:713-955-4302
Mailing Address - Fax:
Practice Address - Street 1:8431 KATY FWY STE 101
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1946
Practice Address - Country:US
Practice Address - Phone:713-955-4302
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75799OtherLPC LICENSE