| Organization Name: | PHOENIX RISING PROFESSIONAL COUNSELING, PC |
| NPI Number: | 1447577101 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TODD CHRISTOPHER DAY (DIRECTOR) |
| Mailing Address: | 302 West Michigan Avenue Paw Paw |
| State: | MI US |
| Postal Code: | 490790026 |
| Phone Number: | 2699989696 |
| Fax Number: | 2694150284 |
| NPI Enumeration Date: | 04/21/2010 |
| NPI Last Update Date: | 04/21/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 6401010792 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |