Active NPI
Rising Up Psychological Services PLLC
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Marquette, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Legal business name
- RISING UP PSYCHOLOGICAL SERVICES PLLC
- Practice address
- 112 W Washington St Ste D
Marquette, MI 49855-4367 - Phone
- (906) 869-8003
- NPI assigned
- Sep 7, 2022
- Last updated
- Sep 7, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Emily Elizabeth Depetro, PSYD
- Title
- Clinical Psychologist
- Phone
- (906) 869-8003
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Primary | ||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X |
Addresses
Primary practice location
112 W Washington St Ste D
Marquette, MI 49855-4367
Mailing address
2202 Fitch Ave
Marquette, MI 49855-1704
Phone (906) 869-8003
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221031002940 | MI | Part B Supplier - Clinic/Group Practice | 3678940855 | Practice locations: Marquette, MI |
National Provider Directory
National Provider DirectoryLocations
112 W Washington St
Ste D
Marquette, MI 49855
Phone (906) 205-5597
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Clinical Psychologist
- Marquette, MI
- NPI 1588385686
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662508800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1662508800000",
"number": "1295456366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2202 FITCH AVE",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498551704",
"telephone_number": "906-869-8003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 W WASHINGTON ST STE D",
"city": "MARQUETTE",
"state": "MI",
"postal_code": "498554367",
"telephone_number": "906-869-8003"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RISING UP PSYCHOLOGICAL SERVICES PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-09-07",
"last_updated": "2022-09-07",
"certification_date": "2022-09-07",
"status": "A",
"authorized_official_last_name": "DEPETRO",
"authorized_official_first_name": "EMILY",
"authorized_official_middle_name": "ELIZABETH",
"authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
"authorized_official_telephone_number": "906-869-8003",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PSYD"
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM0855X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adolescent and Children Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marquette, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.