PHOENIX RISING THERAPY LLC NPI 1235740929

NPI Information

  • NPI: 1235740929
  • Provider Name: PHOENIX RISING THERAPY, LLC
  • Classification: Clinic/Center - 261QM0801X
  • Specialization: Mental Health (Including Community Mental Health Center)
  • Entity Type: Organization
  • Address: 1110 SE ALDER STREET, SUITE 301
    #73
    PORTLAND, OR
    ZIP 97214
  • Phone: (541) 321-0788

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NPI Details

PHOENIX RISING THERAPY, LLC is a mental health (including community mental health center) clinic center in Portland, OR. PHOENIX RISING THERAPY, LLC NPI is 1235740929. The provider is registered as an organization entity type.

The provider's business location address is:

1110 SE ALDER STREET, SUITE 301
#73
PORTLAND, OR
ZIP 97214
Phone: (541) 321-0788
Fax: (541) 735-9465

The provider's authorized official is Cara Freudenberg .
The authorized official title is Licensed Psychologist/owner and has the following contact phone number (541) 321-0788.

The enumeration date for this NPI number is 8/14/2020 and was last updated on 9/20/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11053700559OTHERINDIVIDUAL NPI
2500757076MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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