| Phoenix Rising Therapy, Llc | |
|
1110 Se Alder Street, Suite 301 #73 Portland OR 97214 | |
| (541) 321-0788 | |
| (541) 735-9465 |
| Full Name | Phoenix Rising Therapy, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1110 Se Alder Street, Suite 301, Portland, Oregon |
| Authorized Official Name and Position | Cara Freudenberg (LICENSED PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 5413210788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Rising Therapy, Llc 1110 Se Alder Street, Suite 301, Pmb #73 Portland OR 97214 Ph: (541) 321-0788 | Phoenix Rising Therapy, Llc 1110 Se Alder Street, Suite 301 #73 Portland OR 97214 Ph: (541) 321-0788 |
| NPI Number | 1235740929 |
|---|---|
| Provider Enumeration Date | 08/14/2020 |
| Last Update Date | 09/20/2024 |
| Certification Date | 09/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235740929 | NPI | - | NPPES |
| 1053700559 | Other | INDIVIDUAL NPI | |
| 500757076 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Sandra M. Gonzalez Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1130 Sw Morrison St, Suite 411, Portland, OR 97205 Phone: 503-228-0939 Fax: 503-226-8069 | |
Cascadia Behavioral Healthcare, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9125 Sw 55th Ave, Portland, OR 97219 Phone: 503-238-0769 Fax: 503-477-4598 | |
Edwards Psychotherapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1220 Sw Morrison St, Suite 1100, Portland, OR 97205 Phone: 503-222-0557 | |
Wellpath Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3701 Se Milwaukie Ave Ste D, Portland, OR 97202 Phone: 503-784-2377 | |
Daniel C Donohue, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2931 Ne Broadway St, Portland, OR 97232 Phone: 503-819-2515 | |
Cultivating A New Life Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Se Spokane St Ste 300, Portland, OR 97202 Phone: 541-904-0468 | |
Tiffany Kettermann, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2926 Ne Flanders St Ste 3c, Portland, OR 97232 Phone: 971-270-0167 |