Organization
PHOENIX RISING COUNSELING & CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYETTA L ROSS MS, CSAC, LPC, SAP, (DIRECTOR)
(414) 690-0672
Entity
Organization
Contact information
Practice address
5900 BALCONES DR STE 100, AUSTIN, TX 78731-4298
(414) 690-0672
Mailing address
1711 W CLAYTON CREST AVE, MILWAUKEE, WI 53221-3830
(414) 690-0672
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12088599
CAQH
WI
Enumeration date
02/04/2022
Last updated
02/04/2022
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