Organization Active NPI

Arise Therapy and Life Coaching Center,LLC

  • Community/Behavioral Health Agency
  • Clinton, MD
National Provider Identifier
1427440882
Registry record updated Feb 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
20070 Issued in MD
Legal business name
ARISE THERAPY AND LIFE COACHING CENTER,LLC
Practice address
9135 Piscataway Rd
410
Clinton, MD 20735-2549
Phone
(240) 455-3453
NPI assigned
Feb 23, 2015
Last updated
Feb 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2015

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

Authorized official

Name
Mrs. Kellie Jamison
Title
Clinical Social Worker
Phone
(240) 413-7003

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 20070 MD
Preferred Provider Organization 305R00000X 20070 MD
Mental Illness Community Based Residential Treatment Facility 320800000X 20070 MD
Mental Health Counselor 101YM0800X 20070 MD
Community/Behavioral Health Agency 251S00000X 20070 MD Primary

Addresses

Primary practice location

9135 Piscataway Rd
410
Clinton, MD 20735-2549

Mailing address

12105 Westlock PL
Laurel, MD 20708-2422
Phone (240) 988-2417

National Provider Directory

National Provider Directory

Locations

5410 Indian Head Hwy
Ste 203
Oxon Hill, MD 20745
Phone (240) 606-3691

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.

NPI Registry JSON

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1427440882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12105 WESTLOCK PL",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207082422",
            "telephone_number": "240-988-2417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9135 PISCATAWAY RD",
            "address_2": "410",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352549",
            "telephone_number": "240-455-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARISE THERAPY AND LIFE COACHING CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "JAMISON",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "240-413-7003",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "MD",
            "license": "20070",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "MD",
            "license": "20070",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "MD",
            "license": "20070",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "20070",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "20070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.