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General NPI Number Information
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NPI Number | 1073614129
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Entity Type | Organization
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Legal Business Name | THREE RIVERS FAMILY THERAPY CENTER, INC.
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 09/02/2008
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Provider Practice Location Address
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Address Line | 645 E IRON AVE SUITE B
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City | SALINA
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State | KS
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Zip | 67401-2697
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Country | US
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Telephone | 785-823-6333
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Fax | 785-823-6381
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Provider Business Mailing Address
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Address Line | 645 E IRON AVE SUITE B
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City | SALINA
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State | KS
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Zip | 67401-2697
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Country | US
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Telephone | 785-823-6333
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Fax | 785-823-6381
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Authorized Official
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Title or Position | PARTNER
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Name | MS. CYNTHIA ECKERT-MCCOY MCCOY
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Credential | M.S.W.
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Telephone | 785-823-6333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0924
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License Number State | KS
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