Provider Demographics
NPI:1134490824
Name:RIVER VALLEY COUNSELING LLC
Entity Type:Organization
Organization Name:RIVER VALLEY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEATHERBEE-CAPEN
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:207-364-1610
Mailing Address - Street 1:21 CANAL ST.
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04276
Mailing Address - Country:US
Mailing Address - Phone:207-364-1610
Mailing Address - Fax:207-364-1611
Practice Address - Street 1:21 CANAL ST.
Practice Address - Street 2:
Practice Address - City:RUMFORD
Practice Address - State:ME
Practice Address - Zip Code:04276
Practice Address - Country:US
Practice Address - Phone:207-364-1610
Practice Address - Fax:207-364-1611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME631986251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health