| Rising Spirit Llc | |
|
207 N Boone St Suite 105 Johnson City TN 37604-5675 | |
| (619) 839-9730 | |
| Not Available |
| Full Name | Rising Spirit Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 207 N Boone St, Johnson City, Tennessee |
| Authorized Official Name and Position | Erica Petree (LCSW) |
| Authorized Official Contact | 6198399730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rising Spirit Llc 207 N Boone St Suite 105 Johnson City TN 37604-5675 Ph: () - | Rising Spirit Llc 207 N Boone St Suite 105 Johnson City TN 37604-5675 Ph: (619) 839-9730 |
| NPI Number | 1780499905 |
|---|---|
| Provider Enumeration Date | 02/13/2025 |
| Last Update Date | 02/13/2025 |
| Certification Date | 02/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780499905 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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