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General NPI Number Information
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NPI Number | 1871450486
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Entity Type | Organization
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Legal Business Name | RIVER FOREST THERAPY
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 5887 GLENRIDGE DR STE 230
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City | SANDY SPRINGS
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State | GA
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Zip | 30328-9929
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Country | US
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Telephone | 504-554-0205
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Fax |
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Provider Business Mailing Address
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Address Line | 4766 LAUREL WALK
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City | DUNWOODY
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State | GA
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Zip | 30338-4751
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | BREON GAINES
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Credential | LPC
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Telephone | 504-554-0205
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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