Organization
RIVERBEND THERAPEUTICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY PETERSON LCPC (OWNER)
(406) 781-4973
Entity
Organization
Contact information
Practice address
117 PARK DR S STE A, GREAT FALLS, MT 59401-3612
(406) 781-4973
(406) 403-0222
Mailing address
PO BOX 2851, GREAT FALLS, MT 59403-2851
(406) 781-4973
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
KOVPYU3GG
—
MT
Enumeration date
10/26/2021
Last updated
02/09/2022
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