Organization
RIVERSIDE PSYCHOTHERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURA SUSAN SIKES MA, LPC-MHSP (OFFICE MANAGER/THERAPIST)
(423) 802-6943
Entity
Organization
Contact information
Practice address
3914 SAINT ELMO AVE STE C, CHATTANOOGA, TN 37409-1269
(423) 802-6943
(888) 508-6829
Mailing address
3914 SAINT ELMO AVE STE C, CHATTANOOGA, TN 37409-1269
(423) 802-6943
(888) 508-2869
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2864
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12087518
CAQH PROVIDER ID
TN
01
—
1669636742
NPI INDIVIDUAL NUMBER
TN
Enumeration date
08/27/2013
Last updated
12/06/2021
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