Provider Demographics
NPI:1144594078
Name:RISE HANNAH PAGE DBA PAGE COUNSELING CENTER
Entity type:Organization
Organization Name:RISE HANNAH PAGE DBA PAGE COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RISE
Authorized Official - Middle Name:H
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, NCC
Authorized Official - Phone:407-970-0084
Mailing Address - Street 1:198 HALPINE RD.
Mailing Address - Street 2:APT. 1384
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-7626
Mailing Address - Country:US
Mailing Address - Phone:407-970-0084
Mailing Address - Fax:240-833-3451
Practice Address - Street 1:206 N. ADAMS STREET
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1829
Practice Address - Country:US
Practice Address - Phone:407-970-0084
Practice Address - Fax:240-833-3451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-23
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273427309Medicaid
FL767428700Medicaid