Provider Demographics
NPI:1255925954
Name:RISE UP COUNSELING, LLC
Entity type:Organization
Organization Name:RISE UP COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:RAUN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SKYRM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-256-0533
Mailing Address - Street 1:3 E POLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:PA
Mailing Address - Zip Code:16112-9109
Mailing Address - Country:US
Mailing Address - Phone:234-402-8003
Mailing Address - Fax:330-595-4727
Practice Address - Street 1:3 E POLAND AVE
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:PA
Practice Address - Zip Code:16112-9109
Practice Address - Country:US
Practice Address - Phone:234-402-8003
Practice Address - Fax:330-595-4727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty