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General NPI Number Information
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NPI Number | 1629471446
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Entity Type | Organization
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Legal Business Name | RIVERSIDE COUNSELING CENTER LLC
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Dates
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Enumeration Date | 10/07/2014
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Last Update Date | 10/07/2014
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Provider Practice Location Address
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Address Line | 205 BULLOCKS POINT AVE SUITE 205 B
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City | RIVERSIDE
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State | RI
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Zip | 02915-5336
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Country | US
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Telephone | 401-270-7379
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Fax | 401-270-1824
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Provider Business Mailing Address
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Address Line | 205 BULLOCKS POINT AVE SUITE 205 B
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City | RIVERSIDE
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State | RI
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Zip | 02915-5336
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Country | US
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Telephone | 401-270-7379
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Fax | 401-270-1824
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MS. PATRICIA A AREL
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Credential | LCMHC
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Telephone | 401-270-7379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDP00290
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MHC00181
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License Number State | RI
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