Active NPI
Michael A Rivera, MS
- Pastoral Counselor
- Atlanta, GA
National Provider Identifier
1104964675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- Practice address
- 1000 Parkwood Cir SE
Suite 900
Atlanta, GA 30339-2131 - Phone
- (678) 221-4143
- NPI assigned
- Feb 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | LPC005480 | GA | |
| Pastoral Counselor | 101YP1600X | Primary |
Addresses
Primary practice location
1000 Parkwood Cir SE
Suite 900
Atlanta, GA 30339-2131
Mailing address
1000 Parkwood Cir SE Ste 900
Atlanta, GA 30339-2140
Phone (678) 221-4143
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC005480 | GA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605830400000",
"number": "1104964675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 PARKWOOD CIR SE STE 900",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303392140",
"telephone_number": "678-221-4143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 PARKWOOD CIR SE",
"address_2": "SUITE 900",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303392131",
"telephone_number": "678-221-4143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "MICHAEL",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-04",
"last_updated": "2020-11-20",
"certification_date": "2020-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC005480",
"primary": false
},
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.