Provider Demographics
NPI:1720563950
Name:ONE RIVER FAMILY THERAPY SERVICES
Entity Type:Organization
Organization Name:ONE RIVER FAMILY THERAPY SERVICES
Other - Org Name:ONE RIVER FAMILY THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER /THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FECHTER
Authorized Official - Suffix:
Authorized Official - Credentials:LSCSW
Authorized Official - Phone:785-231-9189
Mailing Address - Street 1:112 SW 6TH AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66603-3850
Mailing Address - Country:US
Mailing Address - Phone:785-231-9189
Mailing Address - Fax:800-708-1339
Practice Address - Street 1:112 SW 6TH AVE STE 206
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66603-3850
Practice Address - Country:US
Practice Address - Phone:785-231-9189
Practice Address - Fax:800-708-1330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS10004130CMedicaid