NPIMap

Organization Active NPI

Riverside Recovery LLC

  • Addiction (Substance Use Disorder) Counselor
  • Lewiston, ID
National Provider Identifier
1366827255
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCPC-2714 Issued in ID
Legal business name
RIVERSIDE RECOVERY LLC
Practice address
1720 18TH Ave
Lewiston, ID 83501-4047
Phone
(208) 746-4097
Fax
(208) 746-2294
NPI assigned
Jul 21, 2015
Last updated
Dec 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Authorized official

Name
Sara Light BennettNPI 1093155566
Title
Owner
Phone
(208) 746-4097

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X LCPC-2714 ID Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LCPC-5714 ID
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

1720 18TH Ave
Lewiston, ID 83501-4047

Mailing address

1720 18TH Ave
Lewiston, ID 83501-4047
Phone (208) 746-4097

Other practice location 1

155 Main Street
Unit #3
Orofino, ID 83544
Phone (208) 746-4097 ext. 20874

Other practice location 2

1708 18th Ave
Lewiston, ID 83501-4047
Phone (208) 746-4097

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251029004646 ID Part B Supplier - Clinic/Group Practice 2567951544 Receives reassigned benefits from 6 practitioners
Practice locations: Lewiston, ID; Orofino, ID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1366827255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 18TH AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014047",
            "telephone_number": "208-746-4097",
            "fax_number": "208-746-2294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 18TH AVE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014047",
            "telephone_number": "208-746-4097",
            "fax_number": "208-746-2294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Main Street",
            "address_2": "Unit #3",
            "address_purpose": "LOCATION",
            "city": "Orofino",
            "state": "ID",
            "postal_code": "83544",
            "country_code": "US",
            "telephone_number": "208-746-4097 x20874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1708 18th Ave",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ID",
            "postal_code": "835014047",
            "country_code": "US",
            "telephone_number": "208-746-4097",
            "fax_number": "208-746-2294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RIVERSIDE RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-21",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "LIGHT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-746-4097"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ID",
            "license": "LCPC-2714",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-5714",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.