MEDICARE: RIVERSTONE WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QR1100X	Research Clinic/Center
2	251S00000X	Community/Behavioral Health Agency
3	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1033921168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERSTONE WELLNESS LLC

Provider Business Mailing Address
First Line	:	2700 ERNEST ST APT 331G
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-8478
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 ERNEST ST APT 331G
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-8478
Country	:	US
Telephone Number	:	228-546-8737
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DARIAN KRASNER
Credential	:	LMSW
Telephone Number	:	228-546-8737

Provider Enumeration Date	:	01/24/2025
Last Update Date	:	11/24/2025

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Directions to “RIVERSTONE WELLNESS LLC ” Practice Location

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