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Organization
RESILIENCE RISING, PLLC
Active
Organization
RESILIENCE RISING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH J. HARRIS LCSW (OWNER/MANAGER)
(224) 534-0331
Entity
Organization
Contact information
Practice address
3411 W DIVERSEY AVE OFC 14, CHICAGO, IL 60647-1245
(224) 534-0331
Mailing address
4648 N LECLAIRE AVE, CHICAGO, IL 60630-3817
(224) 534-0331
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149.018572
LICENSE NUMBER
IL
Enumeration date
12/15/2021
Last updated
12/15/2021
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