NPIMap

Organization Active NPI

Rising Phoenix Psychotherapy & Consulting

  • Social Worker
  • Salem, MA
National Provider Identifier
1316436876
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
110153 Issued in MA
Legal business name
RISING PHOENIX PSYCHOTHERAPY & CONSULTING
Practice address
27 Congress St Ste 205-14
Salem, MA 01970-5595
Phone
(978) 594-0762
Fax
(844) 666-7395
NPI assigned
May 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2018

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

Authorized official

Name
Mr. Christopher R Deiulio, MSW, LICSWNPI 1811020860
Title
Owner
Phone
(978) 594-0762

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 110153 MA Primary

Addresses

Primary practice location

27 Congress St Ste 205-14
Salem, MA 01970-5595

Mailing address

27 Congress St Ste 205-14
Salem, MA 01970-5595
Phone (978) 594-0762

National Provider Directory

National Provider Directory

Locations

27 Congress St
Ste 205-14
Salem, MA 01970
Phone (978) 594-0762

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": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1316436876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 CONGRESS ST STE 205-14",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019705595",
            "telephone_number": "978-594-0762",
            "fax_number": "844-666-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 CONGRESS ST STE 205-14",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019705595",
            "telephone_number": "978-594-0762",
            "fax_number": "844-666-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISING PHOENIX PSYCHOTHERAPY & CONSULTING",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A",
        "authorized_official_last_name": "DEIULIO",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "978-594-0762",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW, LICSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "MA",
            "license": "110153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; 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.