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Organization
RISING PHOENIX COUNSELING LLC
Active
Organization
RISING PHOENIX COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY LUCAS IMFT (OWNER/THERAPIST)
(330) 577-8281
Entity
Organization
Contact information
Practice address
9205 OH 43, STREETSBORO, OH 44241
(734) 625-9260
Mailing address
9374 STATE ROUTE 14 # 1007, STREETSBORO, OH 44241-5224
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/11/2022
Last updated
11/20/2024
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