Provider Demographics
NPI:1578263703
Name:TRAUMA RECOVERY & COUNSELING SERVICES
Entity Type:Organization
Organization Name:TRAUMA RECOVERY & COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:RILES-STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:225-242-9865
Mailing Address - Street 1:18522 BELLINGRATH LAKES AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWELL SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70739-4766
Mailing Address - Country:US
Mailing Address - Phone:225-242-9865
Mailing Address - Fax:
Practice Address - Street 1:8369 FLORIDA BLVD STE 3
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-7862
Practice Address - Country:US
Practice Address - Phone:225-242-9865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty