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General NPI Number Information
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NPI Number | 1821661653
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Entity Type | Organization
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Legal Business Name | RIVER IN EDEN COUNSELING, LLC
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Dates
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Enumeration Date | 07/20/2021
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 926 HADDONFIELD RD # 764
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City | CHERRY HILL
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State | NJ
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Zip | 08002-2775
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Country | US
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Telephone | 609-447-1280
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Fax |
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Provider Business Mailing Address
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Address Line | 926 HADDONFIELD RD # 764
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City | CHERRY HILL
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State | NJ
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Zip | 08002-2775
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Country | US
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Telephone | 609-447-1280
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. SHONDA BROOKS
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Credential |
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Telephone | 609-447-1280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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