Individual provider Active NPI

Mary Rivera

  • Professional Counselor
  • Devine, TX
National Provider Identifier
1356830368
Registry record updated Mar 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
75057 Issued in TX
Practice address
612 E Hondo Ave
Devine, TX 78016-3320
Phone
(830) 444-6281
NPI assigned
May 4, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
75057TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lucid Counseling and Wellness Consultants LLC Current Accepting new patients
South Texas Counseling & Wellness PLLC Professional Current Accepting new patients

Locations

612 E Hondo Ave
Devine, TX 78016
Phone (830) 224-0024

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 and National Provider Directory roles.

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

Verify at the official NPI Registry.