Danette Rivera

Individual provider Active NPI Clinical Social Worker · Spangle, WA

NPI 1407255144 · NPPES record last updated Aug 23, 2023

Key facts

NPI
1407255144
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
SCS61001445 (WA)
Practice address
3025 E Spangle Waverly Rd
Spangle, WA 99031-9703
Phone
(423) 596-2917
NPI assigned
Aug 19, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SCS61001445WAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X SCS61001445 WA Yes

Addresses

Primary practice location

3025 E Spangle Waverly Rd
Spangle, WA 99031-9703

Mailing address

3025 E Spangle Waverly Rd
Spangle, WA 99031-9703

Other providers in Spangle, WA

All providers in Spangle, WA · Clinical Social Worker in Washington

Sources for this page

Verify at the official NPI Registry.