Organization
RIVERSTONE COUNSELING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE GAIL FEDERICO MA NCC LPC (OWNER)
(770) 213-3615
Entity
Organization
Contact information
Practice address
132 RIVERSTONE TER, SUITE 102, CANTON, GA 30114-1703
(770) 213-3615
(678) 880-9813
Mailing address
132 RIVERSTONE TER, SUITE 102, CANTON, GA 30114-1703
(770) 213-3615
(678) 880-9813
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC007159
GA
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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