Renisha C Rivers

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A1903044

Practice address

60 W Sunbridge Dr
Fayetteville, AR 72703-1822

Phone

(479) 695-1240

Fax

(479) 750-4843

NPI assigned

Apr 1, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1245792183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S 48TH ST",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626683",
            "telephone_number": "479-750-2020",
            "fax_number": "479-750-4843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 W SUNBRIDGE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727031822",
            "telephone_number": "479-695-1240",
            "fax_number": "479-750-4843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERS",
        "first_name": "RENISHA",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "A1903044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Mental Health Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.