Provider Demographics
NPI:1134990724
Name:RIVERS AMICK COUNSELING SERVICES
Entity type:Organization
Organization Name:RIVERS AMICK COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TONI
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:AMICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LAC
Authorized Official - Phone:803-834-9643
Mailing Address - Street 1:1930 WASH LEVER RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE MOUNTAIN
Mailing Address - State:SC
Mailing Address - Zip Code:29075-9634
Mailing Address - Country:US
Mailing Address - Phone:803-834-9643
Mailing Address - Fax:
Practice Address - Street 1:1930 WASH LEVER RD
Practice Address - Street 2:
Practice Address - City:LITTLE MOUNTAIN
Practice Address - State:SC
Practice Address - Zip Code:29075-9634
Practice Address - Country:US
Practice Address - Phone:803-834-9643
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TONI AMICK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC15687514444OtherRECORD INSURERS RECORDS