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Organization
CENTER TO RISE WELLNESS SPA STUDIO
Active
Organization
CENTER TO RISE WELLNESS SPA STUDIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE BUTLER LMSW, LCDC-I (CHIEF EXECUTIVE OFFICER)
(817) 987-2651
Entity
Organization
Contact information
Practice address
600 W PARK ROW DR STE A, ARLINGTON, TX 76010-2559
(817) 987-2651
(214) 602-6638
Mailing address
600 W PARK ROW DR STE A, ARLINGTON, TX 76010-2559
(817) 987-2651
(214) 602-6638
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
174400000X
Specialist
—
NULL
174400000X
Specialist
—
—
251B00000X
Case Management Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
261QB0400X
Birthing Clinic/Center
—
NULL
261QC1500X
Community Health Clinic/Center
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
332BC3200X
Customized Equipment (DME)
—
NULL
335E00000X
Prosthetic/Orthotic Supplier
—
NULL
Other
Enumeration date
08/28/2020
Last updated
01/07/2022
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