Provider Demographics
NPI:1528329505
Name:RIVER CITY COUNSELING PC
Entity type:Organization
Organization Name:RIVER CITY COUNSELING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:HIATT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC/MHSP
Authorized Official - Phone:423-933-2575
Mailing Address - Street 1:5819 WINDING LN
Mailing Address - Street 2:SUITE #133
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-3631
Mailing Address - Country:US
Mailing Address - Phone:423-933-2575
Mailing Address - Fax:423-285-6160
Practice Address - Street 1:5819 WINDING LN
Practice Address - Street 2:SUITE #133
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-3631
Practice Address - Country:US
Practice Address - Phone:423-933-2575
Practice Address - Fax:423-285-6160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty