NPIMap

Organization Active NPI

Riverside Counseling Services, LLC

  • Clinical Social Worker
  • Melbourne, FL
National Provider Identifier
1003198409
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9134 Issued in FL
Legal business name
RIVERSIDE COUNSELING SERVICES, LLC
Practice address
1301 W Eau Gallie Blvd Ste 96
Melbourne, FL 32935-5390
Phone
(321) 421-6992
Fax
(321) 421-6993
NPI assigned
Sep 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Timothy Thein, LCSW, CAPNPI 1710125232
Title
Executive Director
Phone
(321) 421-6992

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X SW9134 FL Primary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X

Addresses

Primary practice location

1301 W Eau Gallie Blvd Ste 96
Melbourne, FL 32935-5390

Mailing address

1301 W Eau Gallie Blvd Ste 96
Melbourne, FL 32935-5390
Phone (321) 421-6992

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120706000113 FL Part B Supplier - Clinic/Group Practice 0446415970 Receives reassigned benefits from 6 practitioners
Practice locations: Melbourne, FL

National Provider Directory

National Provider Directory

Locations

1301 W Eau Gallie Blvd
Ste 96
Melbourne, FL 32935
Phone (321) 272-8336

1301 W Eau Gallie Blvd
Ste 105
Melbourne, FL 32935
Phone 3214216992 ext. 105

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751932800000",
    "number": "1003198409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 W EAU GALLIE BLVD STE 96",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355390",
            "telephone_number": "321-421-6992",
            "fax_number": "321-421-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 W EAU GALLIE BLVD STE 96",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355390",
            "telephone_number": "321-421-6992",
            "fax_number": "321-421-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "THEIN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "321-421-6992",
        "authorized_official_credential": "LCSW, CAP"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9134",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.