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General NPI Number Information
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NPI Number | 1932911989
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Entity Type | Organization
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Legal Business Name | RIVERROCK COUNSELING LLC
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 7046 DAWN CT
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55076-2642
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Country | US
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Telephone | 612-203-1317
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2424
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City | INVER GROVE HEIGHTS
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State | MN
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Zip | 55076-8424
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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 | OWNER
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Name | JUSTINA STICH
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Credential | MA
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Telephone | 612-203-1317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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