Provider Demographics
NPI:1700230463
Name:RIVERBRIDGE COUNSELING, INC.
Entity Type:Organization
Organization Name:RIVERBRIDGE COUNSELING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRISSE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:320-493-2893
Mailing Address - Street 1:14451 HIGHWAY 7
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-3740
Mailing Address - Country:US
Mailing Address - Phone:320-493-2893
Mailing Address - Fax:
Practice Address - Street 1:14451 HIGHWAY 7
Practice Address - Street 2:SUITE 2A
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-3740
Practice Address - Country:US
Practice Address - Phone:320-493-2893
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2481106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1629339544Medicaid