Provider Demographics
NPI:1508137969
Name:TWO RIVERS COUNSELING, LLC
Entity Type:Organization
Organization Name:TWO RIVERS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON-TAFT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:304-579-3272
Mailing Address - Street 1:265 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:HARPERS FERRY
Mailing Address - State:WV
Mailing Address - Zip Code:25425-6396
Mailing Address - Country:US
Mailing Address - Phone:304-579-3272
Mailing Address - Fax:
Practice Address - Street 1:409 W KING ST
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-3203
Practice Address - Country:US
Practice Address - Phone:304-579-3272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2010101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty