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General NPI Number Information
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NPI Number | 1225648728
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Entity Type | Individual
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Provider Name | MAKEENA RIVERS RIVERS LMSW
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Gender | Female
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Dates
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Enumeration Date | 08/09/2020
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 318 S DETROIT ST APT 310
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City | LOS ANGELES
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State | CA
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Zip | 90036-3583
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Country | US
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Telephone | 612-644-1376
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Fax |
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Provider Business Mailing Address
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Address Line | 255 NORTH AVE # 1068
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-6450
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 100423
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License Number State | NY
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