Healthcare Provider Details
I. General information
NPI: 1831521145
Provider Name (Legal Business Name): DR NANCY M RIVAS PC FLOURISHING LIVES COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/09/2013
Last Update Date: 09/02/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1805 N MILL ST STE L
NAPERVILLE IL
60563-4860
US
IV. Provider business mailing address
1805 N MILL ST
NAPERVILLE IL
60563-1275
US
V. Phone/Fax
- Phone: 630-881-6604
- Fax:
- Phone: 313-229-3123
- Fax: 331-226-0780
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 071006321 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
NANCY
M
RIVAS
Title or Position: PRESIDENT
Credential: PHD
Phone: 331-229-3123