Healthcare Provider Details

I. General information

NPI: 1083152482
Provider Name (Legal Business Name): RIVER CAIRN COUNSELING, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2017
Last Update Date: 05/12/2021
Certification Date: 05/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4435 O ST STE 212-L
LINCOLN NE
68510-1842
US

IV. Provider business mailing address

5539 S 27TH ST SUITE 104
LINCOLN NE
68512-1648
US

V. Phone/Fax

Practice location:
  • Phone: 402-937-9700
  • Fax:
Mailing address:
  • Phone: 531-289-8246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number1559
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number1559
License Number StateNE

VIII. Authorized Official

Name: MRS. CHRISTINA KELLEY SPINAZZOLA
Title or Position: OWNER, COUNSELOR
Credential: LCSW, LIMHP
Phone: 402-937-9700