NPIMap

Organization Active NPI

Rising Phoenix Counseling Services, LLC

  • Mental Health Counselor
  • Medford, OR
National Provider Identifier
1164952164
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
RISING PHOENIX COUNSELING SERVICES, LLC
Practice address
810 E Jackson St
Medford, OR 97504-6773
Phone
(541) 500-7111
Fax
(541) 507-9118
NPI assigned
Jun 13, 2017
Last updated
Mar 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Sarah May Eilertson, LPC, NCC, CCTPNPI 1972978336
Title
Owner/Counselor/Clinical Director
Phone
(541) 500-7111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary
Registered Dietitian 133V00000X NU
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU

Addresses

Primary practice location

810 E Jackson St
Medford, OR 97504-6773

Mailing address

810 E Jackson St
Medford, OR 97504-6773
Phone (541) 500-7111

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL SimplePractice Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1164952164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 E JACKSON ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046773",
            "telephone_number": "541-500-7111",
            "fax_number": "541-507-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E JACKSON ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046773",
            "telephone_number": "541-500-7111",
            "fax_number": "541-507-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISING PHOENIX COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-13",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "EILERTSON",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "MAY",
        "authorized_official_title_or_position": "OWNER/COUNSELOR/CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "541-500-7111",
        "authorized_official_credential": "LPC, NCC, CCTP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SimplePractice",
            "affiliation": "N",
            "endpointDescription": "Practice Location",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "810 E Jackson St",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975046773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Medford, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.