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NPI Code Detail

MEDICARE: JACQUELINE RIVERS LMFT

MEDICARE: JACQUELINE RIVERS LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist165721NM
2106H00000XMarriage & Family Therapist0180001NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821411679
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELINE RIVERS LMFT
Provider Business Mailing Address
First Line : PO BOX 370
Second Line :
City : HATCH
State : NM
Zip : 87937-0370
Country : US
Telephone Number : 575-267-3280
Fax Number : 575-267-1747
Provider Business Practice Location Address
First Line : 1955 N VALLEY DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88007-5154
Country : US
Telephone Number : 575-523-2772
Fax Number : 575-524-2993
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2014
Last Update Date : 08/08/2016

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Directions to “ JACQUELINE RIVERS LMFT” Practice Location

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