Arise Destiny LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ARISE DESTINY LLC

Practice address

1935 J N Pease PL Ste 101
Charlotte, NC 28262-4541

Phone

(704) 907-8242

Fax

(704) 973-0694

NPI assigned

Feb 23, 2015

Last updated

Dec 13, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vivian Audrey ClarkNPI 1811229362

Title

LCSW/Lisw-CP

Phone

(704) 907-8242

Specialties & licenses 4

Addresses

Locations

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.

• Vivian Audrey Clark, LCSW,LISW-CP

  • Clinical Social Worker
  • Charlotte, NC
  • NPI 1811229362

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1437541877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10211 MERIDALE CROSSING DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282697367",
            "telephone_number": "704-907-8242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 J N PEASE PL STE 101",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624541",
            "telephone_number": "704-907-8242",
            "fax_number": "704-973-0694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARISE DESTINY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-23",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_middle_name": "AUDREY",
        "authorized_official_title_or_position": "LCSW/LISW-CP",
        "authorized_official_telephone_number": "704-907-8242"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Arey Jr.
• Ana Gabriela Arias, RN
• Tracy Marie Arietta, PHARMD
• Arise and Shine Therapy, Inc.
• Arise Beautiful LLC
• Arise Healing Counseling, PLLC.
• Arise Home Care Agency
• Arj SC
• Arj-Cabha
• Arj, LLC

• Community/Behavioral Health Agency in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.