Healthcare Provider Details

I. General information

NPI: 1265379127
Provider Name (Legal Business Name): RIVERSTONE COUNSELING GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 JOHN ADAMS PKWY
IDAHO FALLS ID
83401-4072
US

IV. Provider business mailing address

1434 N 615 E
SHELLEY ID
83274-5077
US

V. Phone/Fax

Practice location:
  • Phone: 208-520-1502
  • Fax:
Mailing address:
  • Phone: 208-520-1502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DALLEN RAY BELL
Title or Position: LCSW/OWNER
Credential:
Phone: 208-520-1502