Healthcare Provider Details

I. General information

NPI: 1982982963
Provider Name (Legal Business Name): ANTHONY RIVERS PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2011
Last Update Date: 07/18/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3244 HENDERSON RD STE 4
COLUMBUS OH
43220-7300
US

IV. Provider business mailing address

3244 HENDERSON RD STE 4
COLUMBUS OH
43220-7300
US

V. Phone/Fax

Practice location:
  • Phone: 614-664-3175
  • Fax: 614-386-1692
Mailing address:
  • Phone: 614-664-3175
  • Fax: 614-386-1692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6935
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: