Individual provider Active NPI

Jeanette Catherine Rivas, LCSW

  • Clinical Social Worker
  • Zionsville, IN
National Provider Identifier
1528224862
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34009129A Issued in IN
Practice address
10801 N Michigan Rd Ste 200
Zionsville, IN 46077-8171
Phone
(216) 468-5000
NPI assigned
Aug 6, 2008
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X SW14852 FL
Clinical Social Worker 1041C0700X 34009129A IN Primary

Addresses

Primary practice location

10801 N Michigan Rd Ste 200
Zionsville, IN 46077-8171

Mailing address

10801 N Michigan Rd Ste 200
Zionsville, IN 46077-8171
Phone (216) 468-5000

Other practice location 1

1437 S Belcher Rd
Clearwater, FL 33764-2829
Phone (541) 322-7500

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW14852FLMDClinical Social Worker
34009129AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Performance Physical Therapy LLC PastSince Jun 26, 2019 Accepting new patients
Inpathy Behavioral Healthcare Group LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jeanette.rivas.1@24284.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1528224862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10801 N MICHIGAN RD STE 200",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460778171",
            "telephone_number": "216-468-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 N MICHIGAN RD STE 200",
            "city": "ZIONSVILLE",
            "state": "IN",
            "postal_code": "460778171",
            "telephone_number": "216-468-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1437 S Belcher Rd",
            "address_purpose": "LOCATION",
            "city": "Clearwater",
            "state": "FL",
            "postal_code": "337642829",
            "country_code": "US",
            "telephone_number": "541-322-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVAS",
        "first_name": "JEANETTE",
        "middle_name": "CATHERINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14852",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009129A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zionsville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.