NPIMap

Organization Active NPI

Rise Wellness Collaborative

  • Clinical Social Worker
  • Saline, MI
National Provider Identifier
1801564265
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
RISE WELLNESS COLLABORATIVE
Practice address
760 Woodland Dr
Saline, MI 48176-1682
Phone
(734) 219-9380
NPI assigned
Sep 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
Jennifer Burke, JD, LMSWNPI 1427492008
Title
Owner/Therapist
Phone
(734) 210-1941

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

760 Woodland Dr
Saline, MI 48176-1682

Mailing address

1900 Carlisle CT
Ypsilanti, MI 48198-3579
Phone (734) 210-1941

Other identifiers 2

IdentifierTypeStateIssuer
1427492008MedicaidMI
1629523634MedicaidMI

National Provider Directory

National Provider Directory

Locations

760 Woodland Dr
Saline, MI 48176
Phone (734) 219-9380

Practitioners & affiliated clinicians

Practitioners 5

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": "1630454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1801564265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CARLISLE CT",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481983579",
            "telephone_number": "734-210-1941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WOODLAND DR",
            "city": "SALINE",
            "state": "MI",
            "postal_code": "481761682",
            "telephone_number": "734-219-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISE WELLNESS COLLABORATIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-01",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "734-210-1941",
        "authorized_official_credential": "JD, LMSW"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427492008",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629523634",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saline, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.