Healthcare Provider Details

I. General information

NPI: 1699687673
Provider Name (Legal Business Name): NICOLE MARIE RIVERS LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 NEWBURY ST STE 202
FRAMINGHAM MA
01701-4581
US

IV. Provider business mailing address

205 NEWBURY ST STE 202
FRAMINGHAM MA
01701-4581
US

V. Phone/Fax

Practice location:
  • Phone: 617-943-8385
  • Fax: 508-302-0507
Mailing address:
  • Phone: 617-332-2282
  • Fax: 508-302-0507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10006883
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: