Active NPI
Eugene Rivera, MSW
- Clinical Social Worker
- Madison, CT
National Provider Identifier
1609129790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 003747
- Practice address
- 20 Laurel Crest Rd
Madison, CT 06443-3344 - Phone
- (203) 245-3467
- NPI assigned
- Oct 26, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 003747 | CT | Primary |
Addresses
Primary practice location
20 Laurel Crest Rd
Madison, CT 06443-3344
Mailing address
20 Laurel Crest Rd
Madison, CT 06443-3344
Phone (203) 245-3467
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
| License | State | Type | Specialty |
|---|---|---|---|
| 003747 | CT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351209600000",
"number": "1609129790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 LAUREL CREST RD",
"city": "MADISON",
"state": "CT",
"postal_code": "064433344",
"telephone_number": "203-245-3467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 LAUREL CREST RD",
"city": "MADISON",
"state": "CT",
"postal_code": "064433344",
"telephone_number": "203-245-3467"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-26",
"last_updated": "2012-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "003747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.