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General NPI Number Information
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NPI Number | 1912259532
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Entity Type | Individual
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Provider Name | DONNAMARIE RIVERA LMFT, LADC
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Gender | Female
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Dates
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Enumeration Date | 10/05/2012
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Last Update Date | 06/10/2019
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Provider Practice Location Address
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Address Line | 2268 MAIN ST STE 2
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City | STRATFORD
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State | CT
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Zip | 06615-5999
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Country | US
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Telephone | 203-909-0157
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Fax |
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Provider Business Mailing Address
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Address Line | 30 COVE BROOK ROAD
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City | WEST HAVEN
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State | CT
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Zip | 06516
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Country | US
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Telephone | 203-909-0157
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 000963
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2053
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2053
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 2053
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License Number State | CT
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