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Organization
RIVERSIDE COUNSELING CENTER PLLC
Active
Organization
RIVERSIDE COUNSELING CENTER PLLC
Active
Other names
Lindsey McClanathan, Riverside Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
KIRSTEN EKBERG (CONTRACTING)
(815) 299-1955
Entity
Organization
Contact information
Practice address
6653 WEAVER RD STE 112, ROCKFORD, IL 61114-8052
(815) 201-2687
Mailing address
6653 WEAVER RD STE 112, ROCKFORD, IL 61114-8052
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
311021632001
—
IL
Enumeration date
11/13/2018
Last updated
12/22/2020
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