Riverplace Counseling Centers Inc

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

8061421CDT Issued in MN

Legal business name

RIVERPLACE COUNSELING CENTERS INC

Practice address

6058 Highway 10 NW
Anoka, MN 55303-4530

Phone

(763) 421-5590

Fax

(763) 427-6876

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Shannon Elizabeth Bookwalter, LIC ALCOHOL AND DRUG

Title

Administrator

Phone

(763) 427-9777

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567123200000",
    "number": "1407976582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6058 HIGHWAY 10 NW",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553034530",
            "telephone_number": "763-421-5590",
            "fax_number": "763-427-6876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6058 HIGHWAY 10 NW",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553034530",
            "telephone_number": "763-421-5590",
            "fax_number": "763-427-6876"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3300 4th Ave",
            "address_purpose": "LOCATION",
            "city": "Anoka",
            "state": "MN",
            "postal_code": "553031161",
            "country_code": "US",
            "telephone_number": "763-421-5590",
            "fax_number": "763-427-6876",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9816 Highway 10",
            "address_purpose": "LOCATION",
            "city": "Elk River",
            "state": "MN",
            "postal_code": "553306239",
            "country_code": "US",
            "telephone_number": "763-421-5590",
            "fax_number": "763-427-6876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RIVERPLACE COUNSELING CENTERS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2019-08-30",
        "status": "A",
        "authorized_official_last_name": "BOOKWALTER",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "763-427-9777",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LIC ALCOHOL AND DRUG"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MN",
            "license": "8061421CDT",
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MN",
            "license": "8083761CDT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REVENUE CODE",
            "identifier": "0949",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "1247315",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROC CODE",
            "identifier": "H2035",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rhonda Johnson, MSW, Licsw LLC
• Hannah Rider
• Fiona Rife
• Catherine Elaine Rincon, LPN
• River Place by Serenity, LLC
• Riverside Family Dental, P.a.
• Phillip Benjamin Rolfe, MD
• Madeline Leigh Rose
• Catherine Rosenberg
• Cary Martha Roussel, RN

• Substance Use Disorder Rehabilitation Clinic/Center in Anoka, MN
• Providers in Anoka, MN by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.