Active NPI
Raeann Rivera, LCSW
- Clinical Social Worker
- Albuquerque, NM
National Provider Identifier
1619281664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C-09609
- Practice address
- 2109 Alhambra Ave SW
Albuquerque, NM 87104-1601 - Phone
- (575) 208-4662
- Fax
- (505) 212-0976
- NPI assigned
- Aug 2, 2010
- Sex
- Female
- Sole proprietor
- No
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 | C-09609 | NM | Primary |
Addresses
Primary practice location
2109 Alhambra Ave SW
Albuquerque, NM 87104-1601
Mailing address
2109 Alhambra Ave SW
Albuquerque, NM 87104-1601
Phone (575) 208-4662
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 |
|---|---|---|---|
| C-09609 | NM | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Community Mental Health Centers, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Raleigh, NC
- NPI 1184859761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619049600000",
"number": "1619281664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2109 ALHAMBRA AVE SW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871041601",
"telephone_number": "575-208-4662",
"fax_number": "505-212-0976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2109 ALHAMBRA AVE SW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871041601",
"telephone_number": "575-208-4662",
"fax_number": "505-212-0976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "RAEANN",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-02",
"last_updated": "2021-04-22",
"certification_date": "2021-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NM",
"license": "C-09609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.