Provider Demographics
NPI:1053482620
Name:RIVER VALLEY WELLNESS CENTER
Entity Type:Organization
Organization Name:RIVER VALLEY WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST LICENSED CLINICAL S
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA LCSW LMFT
Authorized Official - Phone:574-272-7700
Mailing Address - Street 1:227 DIXIEWAY NORTH
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46637-3393
Mailing Address - Country:US
Mailing Address - Phone:574-272-7700
Mailing Address - Fax:574-272-7800
Practice Address - Street 1:227 DIXIEWAY NORTH
Practice Address - Street 2:SUITE 200
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46637-3393
Practice Address - Country:US
Practice Address - Phone:574-272-7700
Practice Address - Fax:574-272-7800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002565A1041C0700X
IN35000335A106H00000X
IN84000027A171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty