Active NPI
Mary Rivera
- Professional Counselor
- Devine, TX
National Provider Identifier
1356830368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 75057
- Practice address
- 612 E Hondo Ave
Devine, TX 78016-3320 - Phone
- (830) 444-6281
- NPI assigned
- May 4, 2018
- Last updated
- Mar 22, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 75057 | TX | Primary |
Addresses
Primary practice location
612 E Hondo Ave
Devine, TX 78016-3320
Mailing address
612 E Hondo Ave
Devine, TX 78016-3320
Phone (830) 444-6281
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 2, 2024 through May 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 75057 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Texas Counseling & Wellness PLLC | Professional | Current | Accepting new patients |
| Lucid Counseling and Wellness Consultants LLC | Current | Accepting new patients |
Locations
612 E Hondo Ave
Devine, TX 78016
Phone (210) 846-2564
Organizations & group practices 2
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.
-
dba Lucid Counseling and Wellness
- Mental Health Counselor
- Devine, TX
- NPI 1639792781
-
- Professional Counselor
- Devine, TX
- NPI 1609582709
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1525392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647907200000",
"number": "1356830368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 E HONDO AVE",
"city": "DEVINE",
"state": "TX",
"postal_code": "780163320",
"telephone_number": "830-444-6281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 E HONDO AVE",
"city": "DEVINE",
"state": "TX",
"postal_code": "780163320",
"telephone_number": "830-444-6281"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-04",
"last_updated": "2022-03-22",
"certification_date": "2022-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "75057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Devine, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.