| Riverside Counseling, Llc | |
|
438 Pennsylvania Ave W Warren PA 16365-2238 | |
| (814) 230-3042 | |
| Not Available |
| Full Name | Riverside Counseling, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 438 Pennsylvania Ave W, Warren, Pennsylvania |
| Authorized Official Name and Position | Joel Patrick Davison (OWNER) |
| Authorized Official Contact | 8142303042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Counseling, Llc 438 Pennsylvania Ave W Warren PA 16365-2238 Ph: (814) 230-3042 | Riverside Counseling, Llc 438 Pennsylvania Ave W Warren PA 16365-2238 Ph: (814) 230-3042 |
| NPI Number | 1972090967 |
|---|---|
| Provider Enumeration Date | 04/16/2018 |
| Last Update Date | 03/01/2022 |
| Certification Date | 03/01/2022 |
| Medicare PECOS PAC ID | 8527319060 |
|---|---|
| Medicare Enrollment ID | O20180924000869 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972090967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CW018306 (Pennsylvania) | Primary |
| Provider Name | Joel P Davison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013311364 PECOS PAC ID: 2567787146 Enrollment ID: I20150203001667 |
| Provider Name | Kristi A Goldthwaite |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710675962 PECOS PAC ID: 0840653887 Enrollment ID: I20230824000436 |
| Provider Name | Zachary C Ransom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538883988 PECOS PAC ID: 1951743871 Enrollment ID: I20240523002198 |
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