Organization Active NPI

Rise Psychotherapy and Family Support Services, PLLC

  • Clinical Social Worker
  • Biloxi, MS
National Provider Identifier
1013663384
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
RISE PSYCHOTHERAPY AND FAMILY SUPPORT SERVICES, PLLC
Practice address
770 Water St Ste 448
Biloxi, MS 39530-4220
Phone
(601) 402-4226
NPI assigned
Feb 25, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sichana Jean
Title
Owner, LCSW
Phone
(228) 679-9738

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

770 Water St Ste 448
Biloxi, MS 39530-4220

Mailing address

770 Water St Ste 448
Biloxi, MS 39530-4220
Phone (228) 679-9738

Other practice location 1

4904 Chamberlain Ave
Gulfport, MS 39507-4345
Phone (601) 402-4226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240814003977 MS Part B Supplier - Clinic/Group Practice 7416495965 Receives reassigned benefits from 4 practitioners
Practice locations: Biloxi, MS

National Provider Directory

National Provider Directory

Locations

770 Water St
Ste 305
Biloxi, MS 39530
Phone (228) 679-9738

770 Water St
Ste 448
Biloxi, MS 39530
Phone (228) 679-9738

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1013663384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 WATER ST STE 448",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395304220",
            "telephone_number": "228-679-9738",
            "fax_number": "228-256-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 WATER ST STE 448",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395304220",
            "telephone_number": "601-402-4226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4904 Chamberlain Ave",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395074345",
            "country_code": "US",
            "telephone_number": "601-402-4226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RISE PSYCHOTHERAPY AND FAMILY SUPPORT SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-25",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "JEAN",
        "authorized_official_first_name": "SICHANA",
        "authorized_official_title_or_position": "OWNER, LCSW",
        "authorized_official_telephone_number": "228-679-9738"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.