| Riverside Counseling Services, Llc | |
|
1301 W Eau Gallie Blvd Suite 105 Melbourne FL 32935-5390 | |
| (321) 421-6992 | |
| (321) 421-6993 |
| Full Name | Riverside Counseling Services, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1301 W Eau Gallie Blvd, Melbourne, Florida |
| Authorized Official Name and Position | Timothy Thein (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3214216992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Counseling Services, Llc 1301 W Eau Gallie Blvd Suite 105 Melbourne FL 32935-5390 Ph: (321) 421-6992 | Riverside Counseling Services, Llc 1301 W Eau Gallie Blvd Suite 105 Melbourne FL 32935-5390 Ph: (321) 421-6992 |
| NPI Number | 1003198409 |
|---|---|
| Provider Enumeration Date | 09/13/2011 |
| Last Update Date | 01/08/2014 |
| Medicare PECOS PAC ID | 0446415970 |
|---|---|
| Medicare Enrollment ID | O20120706000113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003198409 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW9134 (Florida) | Primary |
| Provider Name | Timothy Alan Thein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710125232 PECOS PAC ID: 6608031133 Enrollment ID: I20120706000145 |
| Provider Name | Richard Alfaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285992826 PECOS PAC ID: 0840514907 Enrollment ID: I20150120000921 |
| Provider Name | Catherine Galda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508232281 PECOS PAC ID: 4284921545 Enrollment ID: I20200527001435 |
| Provider Name | Melissa Beth Vandett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043888142 PECOS PAC ID: 4587060082 Enrollment ID: I20210908004182 |
| Provider Name | Jennifer Lynn Paranhos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639593643 PECOS PAC ID: 4284094749 Enrollment ID: I20230714002847 |
| Provider Name | John Stadelman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1215414495 PECOS PAC ID: 7810333762 Enrollment ID: I20240313003229 |
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