MEDICARE: RIVERS ASSOCIATES LLC

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
1	106H00000X	Marriage & Family Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831550649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERS ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	3726 PIEDRAS NEGRAS DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-7671
Country	:	US
Telephone Number	:	575-640-0578
Fax Number	:

Provider Business Practice Location Address
First Line	:	3726 PIEDRAS NEGRAS DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-7671
Country	:	US
Telephone Number	:	575-640-0578
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JACQUELINE RIVERS
Credential	:	LMFT
Telephone Number	:	575-640-0578

Provider Enumeration Date	:	03/08/2016
Last Update Date	:	11/17/2020

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Directions to “RIVERS ASSOCIATES LLC ” Practice Location

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