Provider Demographics
NPI:1588312649
Name:RIVER RISE COUNSELING AND PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:RIVER RISE COUNSELING AND PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JD
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:352-575-0055
Mailing Address - Street 1:3517 NW 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-1055
Mailing Address - Country:US
Mailing Address - Phone:352-870-4574
Mailing Address - Fax:
Practice Address - Street 1:9200 NW 39TH AVE STE 130-3185
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7331
Practice Address - Country:US
Practice Address - Phone:352-575-0055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty