Provider Demographics
NPI:1154998805
Name:RISE COUNSELING SERVICES
Entity type:Organization
Organization Name:RISE COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:V
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-S
Authorized Official - Phone:601-850-8591
Mailing Address - Street 1:711 LAKE HARBOUR DR APT 1228
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-4311
Mailing Address - Country:US
Mailing Address - Phone:601-850-8591
Mailing Address - Fax:769-777-7624
Practice Address - Street 1:711 LAKE HARBOUR DR APT 1228
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-4311
Practice Address - Country:US
Practice Address - Phone:601-850-8591
Practice Address - Fax:769-777-7624
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATASHA V JACKSON DBA RISE COUNSELING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty