| River Of Life Counseling Llc | |
|
1595 W Centre Ave Ste 102 Portage MI 49024-5341 | |
| (269) 246-2458 | |
| Not Available |
| Full Name | River Of Life Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 1595 W Centre Ave Ste 102, Portage, Michigan |
| Authorized Official Name and Position | Mary Beth Houpt (CREDENTIALING) |
| Authorized Official Contact | 5176769788 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River Of Life Counseling Llc Po Box 10 Mason MI 48854-0010 Ph: () - | River Of Life Counseling Llc 1595 W Centre Ave Ste 102 Portage MI 49024-5341 Ph: (269) 246-2458 |
| NPI Number | 1073246658 |
|---|---|
| Provider Enumeration Date | 07/01/2022 |
| Last Update Date | 07/05/2022 |
| Certification Date | 07/05/2022 |
| Medicare PECOS PAC ID | 2860844602 |
|---|---|
| Medicare Enrollment ID | O20240117003912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073246658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | Christy Walker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659780476 PECOS PAC ID: 3779935515 Enrollment ID: I20240117004034 |
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