Active NPI
Elisa Anne Rivard, LMFT
- Marriage & Family Therapist
- Wichita Falls, TX
National Provider Identifier
1558182188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 204528
- Practice address
- 1117 Harlan Ave
Wichita Falls, TX 76306-6146 - Phone
- (940) 613-4930
- NPI assigned
- Oct 17, 2024
- Last updated
- Nov 19, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 204528 | TX | |
| Marriage & Family Therapist | 106H00000X | 204528 | TX | Primary |
Addresses
Primary practice location
1117 Harlan Ave
Wichita Falls, TX 76306-6146
Mailing address
1117 Harlan Ave
Wichita Falls, TX 76306-6146
Phone (940) 613-4930
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 204528 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731974400000",
"number": "1558182188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1117 HARLAN AVE",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763066146",
"telephone_number": "940-613-4930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1117 HARLAN AVE",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763066146",
"telephone_number": "940-613-4930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVARD",
"first_name": "ELISA",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-17",
"last_updated": "2024-11-19",
"certification_date": "2024-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "204528",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "TX",
"license": "204528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wichita Falls, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.