Individual provider Active NPI

Carmita Rivers, LPC

  • Counselor
  • Snellville, GA
National Provider Identifier
1629476395
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
008191 Issued in GA
Practice address
2795 Main Street West
Suite 19B
Snellville, GA 30078-3072
Phone
(404) 671-5895
Fax
(770) 674-7854
NPI assigned
Dec 12, 2014
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 008191 GA Primary
Professional Counselor 101YP2500X NU

Addresses

Primary practice location

2795 Main Street West
Suite 19B
Snellville, GA 30078-3072

Mailing address

PO Box 957676
Duluth, GA 30095-9528

Other practice location 1

3312 Northside Drive
D265
Macon, GA 31210-3007
Phone (404) 671-5895

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
008191GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Management Group, LLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1418342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629476395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 957676",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300959528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 MAIN STREET WEST",
            "address_2": "SUITE 19B",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783072",
            "telephone_number": "404-671-5895",
            "fax_number": "770-674-7854"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3312 Northside Drive",
            "address_2": "D265",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312103007",
            "country_code": "US",
            "telephone_number": "404-671-5895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERS",
        "first_name": "CARMITA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "008191",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.