MEDICARE: AMERICAN RIVER COUNSELING

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1770121246
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN RIVER COUNSELING

Provider Business Mailing Address
First Line	:	3297 TEA ROSE DR
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-6568
Country	:	US
Telephone Number	:	916-847-6427
Fax Number	:

Provider Business Practice Location Address
First Line	:	1845 IRON POINT RD STE 180
Second Line	:
City	:	FOLSOM
State	:	CA
Zip	:	95630-8835
Country	:	US
Telephone Number	:	916-847-6427
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BEVERLY DIANE BALDWIN
Credential	:	LMFT
Telephone Number	:	916-847-6427

Provider Enumeration Date	:	12/16/2019
Last Update Date	:	12/23/2019

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Directions to “AMERICAN RIVER COUNSELING ” Practice Location

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