Provider Demographics
NPI:1871059675
Name:RAISING THE GROUND
Entity type:Organization
Organization Name:RAISING THE GROUND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:OTA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:512-815-3723
Mailing Address - Street 1:595 ROUND ROCK WEST DR STE 104
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-5028
Mailing Address - Country:US
Mailing Address - Phone:512-815-3723
Mailing Address - Fax:
Practice Address - Street 1:595 ROUND ROCK WEST DR STE 104
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5028
Practice Address - Country:US
Practice Address - Phone:512-815-3723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-16
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1043751787OtherNPI
TX1871002311OtherNPI