Rebecca Grace Larivee, LISW
Individual provider Active NPI Clinical Social Worker · Aztec, NM
NPI 1558517037 · NPPES record last updated Mar 8, 2019
Key facts
- NPI
- 1558517037
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- I-06476 (NM)
- Practice address
- 111 W Chaco St
Aztec, NM 87410-1913 - Phone
- (505) 566-0319
- NPI assigned
- Aug 15, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I-06476 | NM | Yes |
| School Social Worker | 1041S0200X | I-06476 | NM |
Addresses
Primary practice location
111 W Chaco St
Aztec, NM 87410-1913
Mailing address
PO Box 1173
Flora Vista, NM 87415-1173
Phone (505) 360-0594
Other providers in Aztec, NM
- Kenneth Kelly
- Ian Thorsten Kirste
- Shyla Kowach
- Diane Kresl
- Annikah Mae Lamery
- Lazy River Therapy Services, LLC
- Phyllis P. Lee
- Scott Lingo
- Sheena Little
- Tausha Renee Ludington I
All providers in Aztec, NM · Clinical Social Worker in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.