779 RIVERSIDE RECOVERY & COUNSELING SERVICES NPI 1437636131

NPI Information

NPI: 1437636131
Provider Name: 779 RIVERSIDE RECOVERY & COUNSELING SERVICES
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

Address:
4940 W 77TH ST
EDINA, MN
ZIP 55435
Phone: (612) 223-6622
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779 RIVERSIDE RECOVERY & COUNSELING SERVICES is an addiction (substance use disorder) counselor in Edina, MN. 779 RIVERSIDE RECOVERY & COUNSELING SERVICES NPI is 1437636131. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4940 W 77TH ST
EDINA, MN
ZIP 55435-805
Phone: (612) 223-6622

The provider's authorized official is Coach Nakumbe .
The authorized official title is Owner / Clinical Director and has the following contact phone number (612) 223-6622.

The enumeration date for this NPI number is 7/25/2018 and was last updated on 7/25/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor		00935	MINNESOTA	No
2	101YM0800X	Counselor	Mental Health	00935	MINNESOTA	No
3	101YP2500X	Counselor	Professional	00935	MINNESOTA	No
4	103TB0200X	Psychologist	Cognitive & Behavioral	00935	MINNESOTA	No
5	103TC0700X	Psychologist	Clinical	00935	MINNESOTA	No
6	103TP2701X	Psychologist	Group Psychotherapy	00935	MINNESOTA	No
7	261QM0850X	Clinic/Center	Adult Mental Health	00935	MINNESOTA	No
8	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	00935	MINNESOTA	No
9	101YA0400X	Counselor	Addiction (Substance Use Disorder)	303344	MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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