Individual provider Active NPI

Shelia Rivers, DSW, LCSW, MPH

  • Clinical Social Worker
  • Gulfport, MS
National Provider Identifier
1003267444
Registry record updated Nov 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C8089 Issued in MS
Practice address
417 Security SQ
Gulfport, MS 39507-1922
Phone
(707) 728-5131
NPI assigned
Jun 27, 2016
Last updated
Nov 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3831C AL
Clinical Social Worker 1041C0700X C8089 MS Primary

Addresses

Primary practice location

417 Security SQ
Gulfport, MS 39507-1922

Mailing address

PO Box 255
Gulfport, MS 39502-0255
Phone (707) 728-5131

Other practice location 1

3350 Ridgelake Dr Ste 297
Metairie, LA 70002-3836
Phone (504) 233-0118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161215000191 MS Practitioner - Clinical Social Worker 1456631100 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

417 Security SQ
Gulfport, MS 39507-1922
Phone (707) 728-5131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3831CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
TBD Acquisition II, LLC Clinical CurrentSince Dec 1, 2017 Accepting new patients
TBD Acquisition II LLC CurrentSince Dec 1, 2017 Accepting new patients
Rivers Psychotherapy Services, LLC CurrentSince Mar 1, 2017 Accepting new patients

Locations

3422 Cleary Ave
Ste B
Metairie, LA 70002
Phone (504) 233-0118

11150 Highway 49
Gulfport, MS 39503
Phone (228) 575-1000

1340 Broad Ave
Ste 410
Gulfport, MS 39501
Phone (228) 575-1775

411 Security Sq
Gulfport, MS 39507
Phone (228) 896-8355

417 Security Sq
Gulfport, MS 39507
Phone (707) 728-5131

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699660800000",
    "number": "1003267444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395020255",
            "telephone_number": "707-728-5131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 SECURITY SQ",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395071922",
            "telephone_number": "707-728-5131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3350 Ridgelake Dr Ste 297",
            "address_purpose": "LOCATION",
            "city": "Metairie",
            "state": "LA",
            "postal_code": "700023836",
            "country_code": "US",
            "telephone_number": "504-233-0118",
            "fax_number": "855-491-1095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERS",
        "first_name": "SHELIA",
        "name_prefix": "Dr.",
        "credential": "DSW, LCSW, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2023-11-11",
        "certification_date": "2023-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "3831C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C8089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.