Provider Demographics
NPI:1609333897
Name:RIVERSTONE COUNSELING, PLLC
Entity Type:Organization
Organization Name:RIVERSTONE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:JESE
Authorized Official - Last Name:CZICHAS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, CDPT
Authorized Official - Phone:360-789-4837
Mailing Address - Street 1:8284 28TH CT NE STE A
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-7161
Mailing Address - Country:US
Mailing Address - Phone:360-789-4837
Mailing Address - Fax:360-890-4099
Practice Address - Street 1:8284 28TH CT NE STE A
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-7161
Practice Address - Country:US
Practice Address - Phone:360-789-4837
Practice Address - Fax:360-890-4099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)