| Rise Up Counseling Services Llc | |
|
530 Corona Del Campo Loop Las Cruces NM 88011-4047 | |
| (575) 680-6075 | |
| (505) 672-7769 |
| Full Name | Rise Up Counseling Services Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 530 Corona Del Campo Loop, Las Cruces, New Mexico |
| Authorized Official Name and Position | Stacey Lynn Scanlon (OWNER) |
| Authorized Official Contact | 5756806075 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rise Up Counseling Services Llc Po Box 45681 Rio Rancho NM 87174-5681 Ph: (505) 226-1960 | Rise Up Counseling Services Llc 530 Corona Del Campo Loop Las Cruces NM 88011-4047 Ph: (575) 680-6075 |
| NPI Number | 1164000501 |
|---|---|
| Provider Enumeration Date | 03/29/2021 |
| Last Update Date | 03/29/2021 |
| Certification Date | 03/29/2021 |
| Medicare PECOS PAC ID | 4688082399 |
|---|---|
| Medicare Enrollment ID | O20210419001554 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164000501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Stacey Scanlon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285059493 PECOS PAC ID: 7214345925 Enrollment ID: I20210510002039 |
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