Provider Demographics
NPI:1902258767
Name:RIGHT ROAD COUNSELING, LLC
Entity Type:Organization
Organization Name:RIGHT ROAD COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, MAC, MCBQS
Authorized Official - Phone:573-616-3007
Mailing Address - Street 1:1808 CRADER DR.
Mailing Address - Street 2:STE. C
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-5614
Mailing Address - Country:US
Mailing Address - Phone:573-616-3007
Mailing Address - Fax:573-616-3008
Practice Address - Street 1:1808 CRADER DR.
Practice Address - Street 2:STE. C
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-5614
Practice Address - Country:US
Practice Address - Phone:573-616-3007
Practice Address - Fax:573-616-3008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X101Y00000X
101YA0400X101YA0400X
101YM0800X101YM0800X
101YP2500X101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty