NPIMap

Organization Active NPI

Rise Up LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brunswick, ME
National Provider Identifier
1811404098
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
CC4601 Issued in ME
Legal business name
RISE UP LLC
Practice address
153 Park Row Ste 103
Brunswick, ME 04011-2053
Phone
(207) 504-3587
NPI assigned
Jan 9, 2018
Last updated
Jan 9, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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

Authorized official

Name
Jessica Packard, LCPCNPI 1740553346
Title
Owner
Phone
(207) 504-3587

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X CC4601 ME Primary
Adult Mental Health Clinic/Center 261QM0850X CC4601 ME
Adolescent and Children Mental Health Clinic/Center 261QM0855X CC4601 ME

Addresses

Primary practice location

153 Park Row Ste 103
Brunswick, ME 04011-2053

Mailing address

153 Park Row Ste 103
Brunswick, ME 04011-2053
Phone (207) 504-3587

National Provider Directory

National Provider Directory

Locations

153 Park Row
Ste 103
Brunswick, ME 04011
Phone (207) 200-5306

Practitioners & affiliated clinicians

Practitioners 7

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": "1515456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515456000000",
    "number": "1811404098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 PARK ROW STE 103",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112053",
            "telephone_number": "207-504-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 PARK ROW STE 103",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112053",
            "telephone_number": "207-504-3587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RISE UP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-09",
        "last_updated": "2018-01-09",
        "status": "A",
        "authorized_official_last_name": "PACKARD",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-504-3587",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "ME",
            "license": "CC4601",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "ME",
            "license": "CC4601",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "ME",
            "license": "CC4601",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

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