Healthcare Provider Details

I. General information

NPI: 1356105167
Provider Name (Legal Business Name): OAK RIVER COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 ANDREWS AVE STE 2
OZARK AL
36360-3706
US

IV. Provider business mailing address

828 ANDREWS AVE STE 2
OZARK AL
36360-3706
US

V. Phone/Fax

Practice location:
  • Phone: 334-443-1030
  • Fax: 334-751-1466
Mailing address:
  • Phone: 334-443-1030
  • Fax: 334-751-1466

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MADDISON KIRSCHNER
Title or Position: OWNER
Credential: LMFTA
Phone: 334-545-4586