Provider Demographics
NPI:1831470491
Name:MOUNTAIN RIVER COUNSELING, LLC
Entity Type:Organization
Organization Name:MOUNTAIN RIVER COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIGID
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:HUNDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:540-219-9137
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-0002
Mailing Address - Country:US
Mailing Address - Phone:540-219-9137
Mailing Address - Fax:304-362-8033
Practice Address - Street 1:544 HARMONY CREEK DR
Practice Address - Street 2:
Practice Address - City:CLINTONVILLE
Practice Address - State:WV
Practice Address - Zip Code:24931-1101
Practice Address - Country:US
Practice Address - Phone:540-219-9137
Practice Address - Fax:304-362-8033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-08
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004770251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health