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Organization

PHOENIX RISINGS COUNSELING CENTER LLC

Active
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Organization

PHOENIX RISINGS COUNSELING CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LYNNE CHANTEL HOLLEY LCSW LCADC (EXECUTIVE DIRECTOR)
(973) 393-0312
Entity
Organization

Contact information

Practice address
50 UNION AVE STE 804B, IRVINGTON, NJ 07111-5221
(770) 568-0619
(973) 629-1741
Mailing address
PO BOX 358, SOUTH ORANGE, NJ 07079-0358
(770) 568-0619
(973) 629-1741

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00259900
NJ
1041C0700X
Clinical Social Worker
Primary
44SC05717900
NJ

Other

Enumeration date
07/14/2017
Last updated
08/21/2017
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