Healthcare Provider Details

I. General information

NPI: 1225437668
Provider Name (Legal Business Name): AARON TIEGER RIVERWOOD LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2014
Last Update Date: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 OLD NORTH RD
WORTHINGTON MA
01098
US

IV. Provider business mailing address

37 ELM ST
SHELBURNE FALLS MA
01370-1508
US

V. Phone/Fax

Practice location:
  • Phone: 413-238-5511
  • Fax:
Mailing address:
  • Phone: 413-992-7792
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: