Provider Demographics
NPI:1023602620
Name:RISE THERAPY & WELLNESS, LLC
Entity type:Organization
Organization Name:RISE THERAPY & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HAMMOND-SUSTEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:678-467-9307
Mailing Address - Street 1:1750 LAKE JEMIKI RD
Mailing Address - Street 2:
Mailing Address - City:WALHALLA
Mailing Address - State:SC
Mailing Address - Zip Code:29691-4238
Mailing Address - Country:US
Mailing Address - Phone:678-467-9307
Mailing Address - Fax:
Practice Address - Street 1:3805 HIGHLANDS HIGHWAY
Practice Address - Street 2:SUITE B
Practice Address - City:WALHALLA
Practice Address - State:SC
Practice Address - Zip Code:29691-2969
Practice Address - Country:US
Practice Address - Phone:678-467-9307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health