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RISING PHOENIX MENTAL WELLNESS, PLLC
NPI 1659208072
Nurse Practitioner - Psychiatric/Mental Health in Conneaut Lake, PA

Active since May 07, 2026
145 WATER ST, CONNEAUT LAKE, PA 16316(814) 230-7921(814) 925-9348 Get Directions Write a Review

NPPES record last updated: May 7, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Rising Phoenix Mental Wellness, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RISING PHOENIX MENTAL WELLNESS, PLLC (NPI 1659208072) is a healthcare organization registered as a psychiatric/mental health in Conneaut Lake, Pennsylvania and active in the NPI registry since May 2026. The organization lists Katelyn Mckibben, Psychiatric Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1659208072
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameRISING PHOENIX MENTAL WELLNESS, PLLC
Location Address145 WATER STConneaut Lake, PA 16316-7279
Mailing Address145 Water StConneaut Lake, PA 16316-7279 · (814) 230-7921 · Fax (814) 925-9348
Phone(814) 230-7921
Fax(814) 925-9348
Organization SubpartNo
Authorized OfficialKatelyn MckibbenPsychiatric Nurse Practitioner · (814) 230-7921
Enumeration DateMay 7, 2026
NPPES CertifiedMay 7, 2026
✔ NPI 1659208072 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
145 WATER ST, Conneaut Lake, PA 16316
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YOUR JOURNEY THERAPY, LLC
Social Worker (Clinical)
145 WATER ST
CONNEAUT LAKE, PA 16316
Crawford County (814) 282-9913

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rising Phoenix Mental Wellness, PLLC's NPI number?

The NPI number for Rising Phoenix Mental Wellness, PLLC is 1659208072. It was assigned to this organization in the NPPES registry on May 7, 2026.

Where is Rising Phoenix Mental Wellness, PLLC located?

Rising Phoenix Mental Wellness, PLLC is located at 145 Water St, Conneaut Lake, PA 16316. The listed phone number is (814) 230-7921.

What is Rising Phoenix Mental Wellness, PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Rising Phoenix Mental Wellness, PLLC was last updated on May 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.