Healthcare Provider Details

I. General information

NPI: 1528317401
Provider Name (Legal Business Name): RIORDAN COUNSELING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2012
Last Update Date: 09/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 N FRANKLIN ST
SEBRING FL
33870-3122
US

IV. Provider business mailing address

2305 ARBUCKLE CREEK RD
SEBRING FL
33870-6888
US

V. Phone/Fax

Practice location:
  • Phone: 863-382-8778
  • Fax: 863-382-7128
Mailing address:
  • Phone: 863-382-8778
  • Fax: 863-382-7128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberMH0432
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberCAP 1158
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT 0201
License Number StateFL

VIII. Authorized Official

Name: MR. GILBERT JAMES RIORDAN
Title or Position: OWNER
Credential: M.A.
Phone: 863-382-8778