Individual provider Active NPI

Maria Del Carmen Rivera, LCSW, MHED

  • Clinical Social Worker
  • Longview, TX
National Provider Identifier
1528080066
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071783 Issued in NY
Practice address
Overton Brooks Vamc Longview Cboc
1005 North Eastman Rd
Longview, TX 75601
Phone
(903) 248-3467
Fax
(405) 456-7625
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 071783 NY Primary

Addresses

Primary practice location

Overton Brooks Vamc Longview Cboc
1005 North Eastman Rd
Longview, TX 75601

Mailing address

1005 N Eastman Rd
Longview, TX 75601-4231
Phone (032) 483-4679

Other identifiers 2

IdentifierTypeStateIssuer
9085OtherPRESTADO LIBRE ASOCIADO DE PUERTO RICO. DEPARTAMENTO DE ESTADO
071783OtherNYLCSW

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
060254NYMDOrthodontics and Dentofacial Orthopedic Dentist
071783NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1528080066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 N EASTMAN RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756014231",
            "telephone_number": "032-483-4679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OVERTON BROOKS VAMC LONGVIEW CBOC",
            "address_2": "1005 NORTH EASTMAN RD",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "75601",
            "telephone_number": "903-248-3467",
            "fax_number": "405-456-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MARIA",
        "middle_name": "DEL CARMEN",
        "credential": "LCSW, MHED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESTADO LIBRE ASOCIADO DE PUERTO RICO. DEPARTAMENTO DE ESTADO",
            "identifier": "9085",
            "state": "PR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "071783",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.