Provider Demographics
NPI:1508137969
Name:TWO RIVERS COUNSELING LLC
Entity type:Organization
Organization Name:TWO RIVERS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON-TAFT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:304-579-3272
Mailing Address - Street 1:224 E LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-1824
Mailing Address - Country:US
Mailing Address - Phone:304-725-7176
Mailing Address - Fax:
Practice Address - Street 1:224 E LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-1824
Practice Address - Country:US
Practice Address - Phone:304-725-7176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-17
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2010101Y00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty