Provider Demographics
NPI:1457502577
Name:RIVER COUNSELING, LLC
Entity type:Organization
Organization Name:RIVER COUNSELING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGEE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:763-444-5567
Mailing Address - Street 1:711 6TH AVE NE STE 1
Mailing Address - Street 2:
Mailing Address - City:ISANTI
Mailing Address - State:MN
Mailing Address - Zip Code:55040-3207
Mailing Address - Country:US
Mailing Address - Phone:763-444-5567
Mailing Address - Fax:763-444-4991
Practice Address - Street 1:711 6TH AVE NE
Practice Address - Street 2:#1
Practice Address - City:ISANTI
Practice Address - State:MN
Practice Address - Zip Code:55040-3207
Practice Address - Country:US
Practice Address - Phone:763-444-5567
Practice Address - Fax:763-444-4991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN746488100Medicaid