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General NPI Number Information
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NPI Number | 1508137969
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Entity Type | Organization
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Legal Business Name | TWO RIVERS COUNSELING LLC
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Dates
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Enumeration Date | 01/17/2012
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 224 E LIBERTY ST
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City | CHARLES TOWN
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State | WV
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Zip | 25414-1824
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Country | US
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Telephone | 304-725-7176
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Fax |
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Provider Business Mailing Address
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Address Line | 224 E LIBERTY ST
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City | CHARLES TOWN
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State | WV
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Zip | 25414-1824
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Country | US
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Telephone | 304-725-7176
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ROBYN HARRISON-TAFT
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Credential | LPC
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Telephone | 304-579-3272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2010
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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