Organization
4 RIVERS COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER YATES (OWNER)
(276) 226-0307
Entity
Organization
Contact information
Practice address
300 FRANKLIN ST STE 236, MARTINSVILLE, VA 24112-2162
(276) 226-0307
Mailing address
300 FRANKLIN ST STE 236, MARTINSVILLE, VA 24112-2162
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30017460770001
—
VA
01
—
N121
MEDICARE
VA
Enumeration date
06/09/2022
Last updated
08/09/2023
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