Basic Information
| Provider Information | |||||||||
| NPI: | 1407306178 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RIVER VALLEY COUNSELING CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 319 BEECH ST | ||||||||
| Address2: | |||||||||
| City: | HOLYOKE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010403968 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135401100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 319 BEECH ST | ||||||||
| Address2: | |||||||||
| City: | HOLYOKE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010403968 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135401100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2016 | ||||||||
| LastUpdateDate: | 10/06/2016 | ||||||||
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| AuthorizedOfficialLastName: | LAFLEUR | ||||||||
| AuthorizedOfficialFirstName: | CANDICE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CLINICIAN | ||||||||
| AuthorizedOfficialTelephone: | 4135342625 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 207593 | MA | Y | Agencies | Community/Behavioral Health |
No ID Information.