| Riverside Counseling Clinic, Llc | |
|
130 S Barstow St Eau Claire WI 54701-3691 | |
| (715) 833-7600 | |
| (715) 833-7116 |
| Full Name | Riverside Counseling Clinic, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 130 S Barstow St, Eau Claire, Wisconsin |
| Authorized Official Name and Position | Sandra E. Willoughby (PARTNER) |
| Authorized Official Contact | 7158337600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Counseling Clinic, Llc 130 S Barstow St Eau Claire WI 54701-3691 Ph: (715) 833-7600 | Riverside Counseling Clinic, Llc 130 S Barstow St Eau Claire WI 54701-3691 Ph: (715) 833-7600 |
| NPI Number | 1417160953 |
|---|---|
| Provider Enumeration Date | 05/08/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417160953 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2375-057 (Wisconsin) | Primary |
| 1041C0700X | Social Worker - Clinical | 6585-123 (Wisconsin) | Primary |
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