# RIVENDELL PSYCHOLOGICAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104569623
- **Authorized official:** BRIAN MCCLINCEY MA (CO-OWNER)
- **Authorized official phone:** (360) 255-8260

## Contact information

- **Practice address:** 410 W BAKERVIEW ROAD, STE 110, OFFICE 148, BELLINGHAM, WA 98226
- **Practice address phone:** (360) 255-8260
- **Practice address fax:** (360) 262-6221
- **Mailing address:** 410 W BAKERVIEW ROAD, STE 110, OFFICE 148, BELLINGHAM, WA 98226
- **Mailing address phone:** (360) 255-8260

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103T00000X | Psychologist | — | NULL | Yes |
| 103T00000X | Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 04/14/2022
- **Last updated:** 04/14/2022