Roberto Riveros, PHD, LPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LPC004905 Issued in GA

Practice address

235 E. Ponce de Leon
Suite 120
Decatur, GA 30030

Phone

(770) 962-7508

Fax

(678) 985-4296

NPI assigned

Jul 27, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Roberto Riveros Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248652800000",
    "number": "1265663140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 E PONCE DE LEON AVE",
            "address_2": "SUITE 120",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300303452",
            "telephone_number": "770-962-7508",
            "fax_number": "678-985-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 E. PONCE DE LEON",
            "address_2": "SUITE 120",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "30030",
            "telephone_number": "770-962-7508",
            "fax_number": "678-985-4296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVEROS",
        "first_name": "ROBERTO",
        "name_prefix": "Mr.",
        "credential": "PHD, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-27",
        "last_updated": "2009-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "LPC004905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROBERTO",
            "last_name": "RIVEROS",
            "prefix": "MR.",
            "credential": "LPC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mark Lee Ritchie, RPH
• Rite Care Pharmacy
• Stephen John Ritz, PH.D.
• Brydy Rivera
• Rossi Rivera
• Marleah Evette Rivers, CRNA
• Megan Roach, MA, BCBA
• Stephanie Lynn Roach, LCSW
• Suzanne Roane, PT
• Anthony Robbins

• Counselor in Decatur, GA
• Providers in Decatur, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; 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.