Phoenix Rising LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6151-125 Issued in WI

Legal business name

PHOENIX RISING LLC

Practice address

N7640 County Road WH Ste 200
Fond Du Lac, WI 54937-7832

Phone

(920) 933-3736

NPI assigned

Jul 20, 2016

Organization subpart

No

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

Authorized official

Name

Chrystal Stephany, MA,LPCNPI 1942675236

Title

Owner

Phone

(920) 251-4214

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Chrystal Stephany, MA,LPC

  • Professional Counselor
  • Fond Du Lac, WI
  • NPI 1942675236
  NPD (past) Authorized official

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491523200000",
    "number": "1356794788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N7640 COUNTY ROAD WH STE 200",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549377832",
            "telephone_number": "920-933-3736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N7640 COUNTY ROAD WH STE 200",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549377832",
            "telephone_number": "920-933-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-20",
        "last_updated": "2017-04-07",
        "status": "A",
        "authorized_official_last_name": "STEPHANY",
        "authorized_official_first_name": "CHRYSTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-251-4214",
        "authorized_official_credential": "MA,LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6151-125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefanie Mae Petrie, APNP
• Galina S Petrinska, M.D.
• Cathy Philipsky
• Craig Robert Phillips
• John S Phillips, D.D.S.
• Shelley D Piasecki, M.D.
• Pickart Hearing Service, LLC
• Pickart Hearing Service, LLC
• Ann Marie Pickart, HEARING INST SPECIAL
• Ashleigh Jo Pickart, HIS

• Professional Counselor in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; 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.