Provider Demographics
NPI:1245191022
Name:GENTLE RISE COUNSELING
Entity type:Organization
Organization Name:GENTLE RISE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWERN
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:AVALLONE
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-CP
Authorized Official - Phone:843-501-1789
Mailing Address - Street 1:1240 WINNOWING WAY UNIT 100
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7531
Mailing Address - Country:US
Mailing Address - Phone:843-501-1789
Mailing Address - Fax:
Practice Address - Street 1:1240 WINNOWING WAY UNIT 100
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7531
Practice Address - Country:US
Practice Address - Phone:843-501-1789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty