| River City Professional Counseling | |
|
1210 Stubbs Ave Monroe LA 71201-5622 | |
| (318) 325-8782 | |
| Not Available |
| Full Name | River City Professional Counseling |
|---|---|
| Speciality | Clinic/Center |
| Location | 1210 Stubbs Ave, Monroe, Louisiana |
| Authorized Official Name and Position | Deborah Lynn Doublin (ADMINISTRATOR) |
| Authorized Official Contact | 3183258748 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River City Professional Counseling 1210 Stubbs Ave Monroe LA 71201-5622 Ph: (318) 325-8782 | River City Professional Counseling 1210 Stubbs Ave Monroe LA 71201-5622 Ph: (318) 325-8782 |
| NPI Number | 1710169503 |
|---|---|
| Provider Enumeration Date | 12/04/2007 |
| Last Update Date | 06/15/2023 |
| Certification Date | 06/15/2023 |
| Medicare PECOS PAC ID | 2264627835 |
|---|---|
| Medicare Enrollment ID | O20101109000260 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710169503 | NPI | - | NPPES |
| 2203782133 | Other | LA | BEHAVIORAL HEALTH LICENSE |
| 5DQ56 | Other | MEDICARE | |
| 2203782133 | Other | LA | SUBSTANCE ABUSE FACILITY LICENSE |
| Provider Name | Deborah L Doublin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104846716 PECOS PAC ID: 9739127044 Enrollment ID: I20050418001284 |
| Provider Name | Tamara Elaine Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487024063 PECOS PAC ID: 9931517570 Enrollment ID: I20210420000477 |
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