Riverwood Counseling, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RIVERWOOD COUNSELING, LLC

Practice address

2003 Kootenai Health Way
Ste 310
Coeur D Alene, ID 83814-6051

Phone

(208) 765-4795

Fax

(208) 765-2903

NPI assigned

Jul 25, 2006

Organization subpart

No

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

Authorized official

Name

Patty Bullick

Title

Owner

Phone

(208) 765-4795

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343260800000",
    "number": "1639192552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 478",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838160478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 KOOTENAI HEALTH WAY",
            "address_2": "STE 310",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146051",
            "telephone_number": "208-765-4795",
            "fax_number": "208-765-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERWOOD COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2012-07-26",
        "status": "A",
        "authorized_official_last_name": "BULLICK",
        "authorized_official_first_name": "PATTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-765-4795"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807261800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marthamary Rinkavage
• Sheila Ripley, MS CPRP
• Andrea Riske
• Riverside Counseling, Inc
• Riverstone Dental Care
• RMC Personal Care, LLC
• Robert a Ebert, DDS
• Kyle Allen Roberts, PHARMD
• Lesley Susanne Roberts, PA-C
• Jessica Robichaud, LMFT, LCPC

• Clinical Social Worker in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; 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.