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General NPI Number Information
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NPI Number | 1861348252
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Entity Type | Organization
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Legal Business Name | RIVERDELL THERAPY AND WELLNESS LLC
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 10 RIVERSIDE DR STE 208
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City | LAKEVILLE
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State | MA
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Zip | 02347-1698
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Country | US
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Telephone | 508-552-8292
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Fax |
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Provider Business Mailing Address
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Address Line | 10 RIVERSIDE DR STE 208
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City | LAKEVILLE
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State | MA
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Zip | 02347-1698
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Country | US
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Telephone | 508-552-8292
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | REBECCA LUNDGREN
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Credential | LICSW
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Telephone | 508-649-2913
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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