Provider Demographics
NPI:1548878085
Name:RIVER'S EDGE COUNSELING
Entity type:Organization
Organization Name:RIVER'S EDGE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LUND
Authorized Official - Suffix:
Authorized Official - Credentials:MS, NCC, LPC-MH
Authorized Official - Phone:605-848-6765
Mailing Address - Street 1:PO BOX 672
Mailing Address - Street 2:
Mailing Address - City:POLLOCK
Mailing Address - State:SD
Mailing Address - Zip Code:57648-0672
Mailing Address - Country:US
Mailing Address - Phone:605-661-7677
Mailing Address - Fax:833-266-6765
Practice Address - Street 1:318 OAHE ST
Practice Address - Street 2:
Practice Address - City:POLLOCK
Practice Address - State:SD
Practice Address - Zip Code:57648-2403
Practice Address - Country:US
Practice Address - Phone:605-848-4957
Practice Address - Fax:833-266-6765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health