Organization
ARISE THERAPY AND LIFE COACHING CENTER,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLIE JAMISON (CLINICAL SOCIAL WORKER)
(240) 413-7003
Entity
Organization
Contact information
Practice address
9135 PISCATAWAY RD, 410, CLINTON, MD 20735-2549
(240) 455-3453
Mailing address
12105 WESTLOCK PL, LAUREL, MD 20708-2422
(240) 988-2417
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
20070
MD
251S00000X
Community/Behavioral Health Agency
Primary
20070
MD
273R00000X
Psychiatric Hospital Unit
20070
MD
305R00000X
Preferred Provider Organization
20070
MD
320800000X
Mental Illness Community Based Residential Treatment Facility
20070
MD
Other
Enumeration date
02/23/2015
Last updated
02/23/2015
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