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NPI Code Detail

MEDICARE: EMILY RIVERS LMSW, CACP

MEDICARE: EMILY RIVERS LMSW, CACP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker9784SC

General Provider Information

NPI Number : 1215288725
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY RIVERS LMSW, CACP
Provider Business Mailing Address
First Line : 448 COLONY LAKES DR
Second Line :
City : LEXINGTON
State : SC
Zip : 29073-6702
Country : US
Telephone Number : 803-920-6518
Fax Number :
Provider Business Practice Location Address
First Line : 1068 S LAKE DR
Second Line :
City : LEXINGTON
State : SC
Zip : 29073-3720
Country : US
Telephone Number : 803-726-9424
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2012
Last Update Date : 10/28/2013

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