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General NPI Number Information
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NPI Number | 1720372543
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Entity Type | Organization
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Legal Business Name | RIVERSTONES COUNSELING, LLC
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 06/09/2011
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Provider Practice Location Address
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Address Line | 180 MAIN ST
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City | NORWAY
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State | ME
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Zip | 04268-5643
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Country | US
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Telephone | 207-739-2646
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 526
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City | NORWAY
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State | ME
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Zip | 04268-0526
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Country | US
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Telephone | 207-739-2646
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | BONNIE SPENCER
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Credential | LCSW
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Telephone | 207-739-2646
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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 | CC2197
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License Number State | ME
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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 | LC10606
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License Number State | ME
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