Provider Demographics
NPI:1548214752
Name:RIVER VALLEY COUNSELING, LLC
Entity Type:Organization
Organization Name:RIVER VALLEY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-689-6700
Mailing Address - Street 1:131 N EWING ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-3383
Mailing Address - Country:US
Mailing Address - Phone:740-689-6700
Mailing Address - Fax:740-689-6702
Practice Address - Street 1:131 N EWING ST
Practice Address - Street 2:UNIT B
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3383
Practice Address - Country:US
Practice Address - Phone:740-689-6700
Practice Address - Fax:740-689-6702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000385283OtherANTHEM BCBS
OH829430 000OtherMAGELLAN BEHAVIOR HEALTH
OH9360171OtherMEDICARE PTAN