Healthcare Provider Details

I. General information

NPI: 1245057702
Provider Name (Legal Business Name): GINGER RIVERA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2024
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 DRY CREEK DR STE 100-B
LONGMONT CO
80503-6409
US

IV. Provider business mailing address

1630 DRY CREEK DR STE 100-B
LONGMONT CO
80503-6409
US

V. Phone/Fax

Practice location:
  • Phone: 970-310-3406
  • Fax: 888-965-4615
Mailing address:
  • Phone: 970-310-3406
  • Fax: 888-965-4615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLSW.0009926937
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: