Provider Demographics
NPI:1801496054
Name:RYSE THERAPEUTIC COUNSELING LLC
Entity type:Organization
Organization Name:RYSE THERAPEUTIC COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:INYANG
Authorized Official - Middle Name:E
Authorized Official - Last Name:UDO-EMA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:480-744-3288
Mailing Address - Street 1:461 W HOLMES AVE UNIT 181
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-5181
Mailing Address - Country:US
Mailing Address - Phone:480-744-3288
Mailing Address - Fax:
Practice Address - Street 1:461 W HOLMES AVE UNIT 181
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-5181
Practice Address - Country:US
Practice Address - Phone:480-744-3288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty