Provider Demographics
NPI:1730946120
Name:RISING PHOENIX COUNSELING ASSOCIATES
Entity type:Organization
Organization Name:RISING PHOENIX COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHERIE
Authorized Official - Middle Name:JUSTINE
Authorized Official - Last Name:POSIE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:313-293-7460
Mailing Address - Street 1:19387 YONKA ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-1827
Mailing Address - Country:US
Mailing Address - Phone:313-293-7460
Mailing Address - Fax:313-488-0131
Practice Address - Street 1:29556 SOUTHFIELD RD STE 150
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2071
Practice Address - Country:US
Practice Address - Phone:313-293-7460
Practice Address - Fax:313-488-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)