Provider Demographics
NPI:1093147530
Name:NEW RIVER COUNSELING ,PLLC
Entity type:Organization
Organization Name:NEW RIVER COUNSELING ,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:DELIA
Authorized Official - Last Name:SUDMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:858-254-5870
Mailing Address - Street 1:108 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:SNEADS FERRY
Mailing Address - State:NC
Mailing Address - Zip Code:28460-9415
Mailing Address - Country:US
Mailing Address - Phone:858-254-5870
Mailing Address - Fax:800-894-8617
Practice Address - Street 1:634 RIVA RIDGE RD
Practice Address - Street 2:SNEADS FERRY NC
Practice Address - City:SNEADS FERRY
Practice Address - State:NC
Practice Address - Zip Code:28460-9330
Practice Address - Country:US
Practice Address - Phone:858-254-5870
Practice Address - Fax:800-894-8617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3321101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty