Provider Demographics
NPI:1013663384
Name:RISE PSYCHOTHERAPY AND FAMILY SUPPORT SERVICES, PLLC
Entity type:Organization
Organization Name:RISE PSYCHOTHERAPY AND FAMILY SUPPORT SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LCSW
Authorized Official - Prefix:
Authorized Official - First Name:SICHANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-679-9738
Mailing Address - Street 1:770 WATER ST STE 448
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39530-4220
Mailing Address - Country:US
Mailing Address - Phone:228-679-9738
Mailing Address - Fax:228-256-6008
Practice Address - Street 1:770 WATER ST STE 448
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39530-4220
Practice Address - Country:US
Practice Address - Phone:601-402-4226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty