Organization
PHOENIX RISING MENTAL HEALTH GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE STARK LCSW (OWNER)
(317) 502-4516
Entity
Organization
Contact information
Practice address
6551 W STONES CROSSING RD, GREENWOOD, IN 46143-9117
(317) 502-4516
Mailing address
6551 W STONES CROSSING RD, GREENWOOD, IN 46143-9117
(317) 502-4516
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/17/2025
Last updated
11/17/2025
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