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General NPI Number Information
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NPI Number | 1316786999
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Entity Type | Organization
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Legal Business Name | RIVER ROOT COUNSELING
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Dates
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Enumeration Date | 05/22/2024
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 2930 EDISON ST NW
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City | UNIONTOWN
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State | OH
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Zip | 44685-8000
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Country | US
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Telephone | 330-595-4563
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Fax |
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Provider Business Mailing Address
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Address Line | 2930 EDISON ST NW
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City | UNIONTOWN
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State | OH
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Zip | 44685-8000
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIELLE OLDER
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Credential | LISW-S
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Telephone | 330-595-4594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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