Active NPI
Riverside Counseling, LLC
- Community/Behavioral Health Agency
- Warren, PA
National Provider Identifier
1972090967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- CW018306
- Legal business name
- RIVERSIDE COUNSELING, LLC
- Practice address
- 438 Pennsylvania Ave W
Warren, PA 16365-2238 - Phone
- (814) 230-3042
- NPI assigned
- Apr 16, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Joel Patrick Davison, L.C.S.W.
- Title
- Owner
- Phone
- (814) 230-3042
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | CW018306 | PA | Primary |
Addresses
Primary practice location
438 Pennsylvania Ave W
Warren, PA 16365-2238
Mailing address
438 Pennsylvania Ave W
Warren, PA 16365-2238
Phone (814) 230-3042
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180924000869 | PA | Part B Supplier - Clinic/Group Practice | 8527319060 |
Receives reassigned benefits from 7 practitioners Practice locations: Warren, PA |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Warren, PA
- NPI 1477315182
-
- Mental Health Counselor
- Warren, PA
- NPI 1629905559
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523836800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1646092800000",
"number": "1972090967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "438 PENNSYLVANIA AVE W",
"city": "WARREN",
"state": "PA",
"postal_code": "163652238",
"telephone_number": "814-230-3042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "438 PENNSYLVANIA AVE W",
"city": "WARREN",
"state": "PA",
"postal_code": "163652238",
"telephone_number": "814-230-3042"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RIVERSIDE COUNSELING, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-04-16",
"last_updated": "2022-03-01",
"certification_date": "2022-03-01",
"status": "A",
"authorized_official_last_name": "DAVISON",
"authorized_official_first_name": "JOEL",
"authorized_official_middle_name": "PATRICK",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "814-230-3042",
"authorized_official_credential": "L.C.S.W."
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "PA",
"license": "CW018306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warren, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; 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.