# PHOENIX RISING CENTERS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376276832
- **Authorized official:** MADRONE B. PHOENIX LICSW (OWNER)
- **Authorized official phone:** (401) 441-5834

## Contact information

- **Practice address:** 1 RICHMOND SQ STE 350W, PROVIDENCE, RI 02906-5165
- **Practice address phone:** (401) 441-5834
- **Mailing address:** 1 RICHMOND SQ STE 350W, PROVIDENCE, RI 02906-5165
- **Mailing address phone:** (401) 441-5834
- **Mailing address fax:** (401) 210-8248

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |
| 106H00000X | Marriage & Family Therapist | — | NULL | — |
| 106H00000X | Marriage & Family Therapist | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/02/2022
- **Last updated:** 08/26/2026