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General NPI Number Information
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NPI Number | 1326649542
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Entity Type | Organization
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Legal Business Name | VIVARIA COUNSELING, PLC
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 1169 EASTERN PKWY STE 1159
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City | LOUISVILLE
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State | KY
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Zip | 40217-1462
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Country | US
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Telephone | 502-272-4950
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Fax |
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Provider Business Mailing Address
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Address Line | 3602 KAHLERT AVE
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City | LOUISVILLE
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State | KY
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Zip | 40215-1815
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Country | US
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Telephone | 502-418-9312
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIN R RIEDEL
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Credential | LCSW
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Telephone | 502-272-4950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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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