Provider Demographics
NPI:1386320968
Name:RIVERS EDGE COUNSELING SERVICES PLLC
Entity type:Organization
Organization Name:RIVERS EDGE COUNSELING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:D
Authorized Official - Last Name:HEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-354-5086
Mailing Address - Street 1:2400 BYRON LN
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48855-9406
Mailing Address - Country:US
Mailing Address - Phone:810-354-5086
Mailing Address - Fax:
Practice Address - Street 1:2400 BYRON LN
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48855-9406
Practice Address - Country:US
Practice Address - Phone:810-354-5086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)