Provider Demographics
NPI:1588379382
Name:RESTORATIVE RISING THERAPY
Entity type:Organization
Organization Name:RESTORATIVE RISING THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ LMFT
Authorized Official - Prefix:
Authorized Official - First Name:MARCI
Authorized Official - Middle Name:
Authorized Official - Last Name:KENNELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:484-883-9137
Mailing Address - Street 1:355 HALL ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-3524
Mailing Address - Country:US
Mailing Address - Phone:484-883-9137
Mailing Address - Fax:
Practice Address - Street 1:355 HALL ST
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-3524
Practice Address - Country:US
Practice Address - Phone:484-883-9137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty