| River Pines Counseling Llc | |
|
105 New England Pl Ste 150 Stillwater MN 55082-2036 | |
| (952) 250-0909 | |
| Not Available |
| Full Name | River Pines Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 105 New England Pl Ste 150, Stillwater, Minnesota |
| Authorized Official Name and Position | Rod Stivland (OWNER) |
| Authorized Official Contact | 9522500909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| River Pines Counseling Llc 105 New England Pl Ste 150 Stillwater MN 55082-2036 Ph: (952) 250-0909 | River Pines Counseling Llc 105 New England Pl Ste 150 Stillwater MN 55082-2036 Ph: (952) 250-0909 |
| NPI Number | 1730828245 |
|---|---|
| Provider Enumeration Date | 06/02/2022 |
| Last Update Date | 06/02/2022 |
| Certification Date | 06/02/2022 |
| Medicare PECOS PAC ID | 5597146829 |
|---|---|
| Medicare Enrollment ID | O20220719000344 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730828245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Darcy L Stivland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700342029 PECOS PAC ID: 5395130959 Enrollment ID: I20220317000227 |
| Provider Name | Rodney Stivland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831838341 PECOS PAC ID: 0244611531 Enrollment ID: I20220718002865 |
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