Provider Demographics
NPI:1427714104
Name:RISE AND SHINE THERAPEUTIC SERVICES LLC
Entity type:Organization
Organization Name:RISE AND SHINE THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HADJA
Authorized Official - Middle Name:I
Authorized Official - Last Name:DANCAY-BYNOE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, NCC
Authorized Official - Phone:301-960-8462
Mailing Address - Street 1:7855 CROSSBAY DR
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-1661
Mailing Address - Country:US
Mailing Address - Phone:301-254-2090
Mailing Address - Fax:
Practice Address - Street 1:7855 CROSSBAY DR
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-1661
Practice Address - Country:US
Practice Address - Phone:301-254-2090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health