Organization Active NPI

Rising Phoenix Counseling, LLC

  • Marriage & Family Therapist
  • Orange City, FL
National Provider Identifier
1093277048
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
RISING PHOENIX COUNSELING, LLC
Practice address
366 E Graves Ave Ste D
Orange City, FL 32763-5266
Phone
(407) 777-2596
NPI assigned
Apr 1, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Authorized official

Name
Mr. David Allen Martin, LMFT
Title
Owner
Phone
(386) 837-2362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

366 E Graves Ave Ste D
Orange City, FL 32763-5266

Mailing address

130 Sunrise Blvd
Debary, FL 32713-3849
Phone (386) 837-2362

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1554076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1093277048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SUNRISE BLVD",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327133849",
            "telephone_number": "386-837-2362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 E GRAVES AVE STE D",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327635266",
            "telephone_number": "407-777-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISING PHOENIX COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-837-2362",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.