=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700674314
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RIVER BIRCH COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2025
-----------------------------------------------------
Last Update Date | 04/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 516 N ROLLING RD STE 305
-----------------------------------------------------
City | CATONSVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21228-4142
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-863-8560
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2214 KEN OAK RD
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21209-4438
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-226-4344
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ MENTAL HEALTH THERAPIST
-----------------------------------------------------
Name | LINDSAY MCCLUNE
-----------------------------------------------------
Credential | LCSW-C
-----------------------------------------------------
Telephone | 206-226-4344
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------