Raven Rivera, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.026113 Issued in IL

Practice address

40450 W Molly LN
Maricopa, AZ 85138-5159

Phone

(773) 526-9746

NPI assigned

Nov 10, 2023

Last updated

Nov 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: raven.rivera.1@23300.direct.athenahealth.com

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

{
    "created_epoch": "1699574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1538933445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40450 W MOLLY LN",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851385159",
            "telephone_number": "773-526-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40450 W MOLLY LN",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851385159",
            "telephone_number": "773-526-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "RAVEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-10",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.026113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Repairing the Bridge Behavioral Health Services PLLC
• Laura Riccobono, PHARMD
• Tamika A Rice
• Natalia Richmond, PA-C
• Hiram A. Rivera Padilla, MD
• Tatiyanna D Roberts
• Kristen Robertson, REGISTERED NURSE
• Cathy Jo Rogers, R.N.
• Nicholas Robert Romans, DMD, MSD
• Anamaria Romero

• Clinical Social Worker in Maricopa, AZ
• Providers in Maricopa, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.