Healthcare Provider Details

I. General information

NPI: 1356432751
Provider Name (Legal Business Name): SARA MARIE RIVET LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA KENDALL

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 INTERSTATE DR
WEST SPRINGFIELD MA
01089-5100
US

IV. Provider business mailing address

56 WORONOCO RD
BLANDFORD MA
01008-9553
US

V. Phone/Fax

Practice location:
  • Phone: 774-206-1125
  • Fax: 774-628-9657
Mailing address:
  • Phone: 413-519-0497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113152
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: