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General NPI Number Information
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NPI Number | 1649956830
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Entity Type | Individual
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Provider Name | ELISSA RIACH LPC
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Gender | Female
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Dates
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Enumeration Date | 06/23/2023
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 7345 E US HIGHWAY 80
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City | LONGVIEW
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State | TX
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Zip | 75605-6757
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Country | US
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Telephone | 903-668-2173
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Fax |
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Provider Business Mailing Address
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Address Line | 7109 JOHN MCCAIN RD
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City | COLLEYVILLE
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State | TX
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Zip | 76034-6803
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Country | US
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Telephone | 817-781-0395
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 90011
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License Number State | TX
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