Healthcare Provider Details

I. General information

NPI: 1144151077
Provider Name (Legal Business Name): RIVERBANK WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 COLLEGE PARK PLZ STE 215
JOHNSTOWN PA
15904-2833
US

IV. Provider business mailing address

112 SPRING RD
HOLLSOPPLE PA
15935-7410
US

V. Phone/Fax

Practice location:
  • Phone: 757-814-3436
  • Fax:
Mailing address:
  • Phone: 757-814-3436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: KARLA SUE COUGHENOUR
Title or Position: OWNER
Credential: LPC, LCMHC, RD, LDN
Phone: 757-814-3436