Provider Demographics
NPI:1700592847
Name:RISING ANCHOR INDIVIDUAL MARRIAGE AND FAMILY THERAPY INC
Entity type:Organization
Organization Name:RISING ANCHOR INDIVIDUAL MARRIAGE AND FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:401-824-4540
Mailing Address - Street 1:203 WASHINGTON ST # 121
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3607
Mailing Address - Country:US
Mailing Address - Phone:424-571-9768
Mailing Address - Fax:
Practice Address - Street 1:777 S ALAMEDA ST FL 2
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90021-1657
Practice Address - Country:US
Practice Address - Phone:424-571-9768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty