Provider Demographics
NPI:1114338118
Name:RIVER VALLY COUNSELING
Entity Type:Organization
Organization Name:RIVER VALLY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SCHOOL PSYCHOLOGIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC MED
Authorized Official - Phone:918-647-6513
Mailing Address - Street 1:34183 COUNTRY CLUB LN
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-9122
Mailing Address - Country:US
Mailing Address - Phone:918-647-7641
Mailing Address - Fax:918-647-2926
Practice Address - Street 1:34183 COUNTRY CLUB LN
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-9122
Practice Address - Country:US
Practice Address - Phone:918-647-7641
Practice Address - Fax:918-647-2926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPC UNDERSUPERVISION251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health