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General NPI Number Information
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NPI Number | 1093217259
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Entity Type | Individual
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Provider Name | NOEMI RIVERA LPC
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Gender | Female
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Dates
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Enumeration Date | 03/05/2018
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Last Update Date | 12/27/2019
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Provider Practice Location Address
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Address Line | 1 COLONY ST
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City | MERIDEN
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State | CT
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Zip | 06451-3210
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Country | US
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Telephone | 203-440-4622
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Fax | 203-440-4625
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Provider Business Mailing Address
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Address Line | 15 EDGAR ST
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City | NEW HAVEN
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State | CT
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Zip | 06519-2318
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Country | US
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Telephone | 203-442-4320
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 46.003386
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License Number State | CT
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