# ARISE THERAPY AND LIFE COACHING CENTER, LLC

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

## Provider details

- **NPI number:** 1679951404
- **Authorized official:** MRS. KELLIE I JAMISON MSW, LCSW-C (OWNER/OPERATOR)
- **Authorized official phone:** (240) 348-6104

## Contact information

- **Practice address:** 9135 PISCATAWAY ROAD., SUITE 245, CLINTON, MD 20735-2555
- **Practice address phone:** (240) 348-6104
- **Practice address fax:** (301) 856-3051
- **Mailing address:** 9135 PISCATAWAY ROAD, SUITE 245, CLINTON, MD 20735-2555
- **Mailing address phone:** (240) 348-6104
- **Mailing address fax:** (301) 856-3051

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 05/13/2015
- **Last updated:** 05/13/2015