Anissa Rivers, PSYD, HSPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042306A Issued in IN

Practice address

3903 Indianapolis Blvd
East Chicago, IN 46312-2555

Phone

(219) 398-7050

Fax

(219) 392-6998

NPI assigned

Mar 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southlake Community Mental Health Center Inc.

  • Clinic/Center
  • Merrillville, IN
  • NPI 1821081290
  NPD

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1689703043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 LOUISIANA ST",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464106385",
            "telephone_number": "219-757-1928",
            "fax_number": "219-757-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 INDIANAPOLIS BLVD",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463122555",
            "telephone_number": "219-398-7050",
            "fax_number": "219-392-6998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERS",
        "first_name": "ANISSA",
        "name_prefix": "Dr.",
        "credential": "PSYD, HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-03",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042306A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200934220",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000611096",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Xavier Zaire Rias
• Lashawn Overzenia Richardson-Weems
• Josephine T Richardson
• Ralph William Richter Jr., MD
• Geoffrey Ritter, PT, DPT
• Cherokee N Robinson Smith
• Carmen C Rodriguez, LCSW
• Michael Rodriguez, PHARMD
• Adrienne Rodriquez
• Mayte Rodriquez

• Clinical Psychologist in East Chicago, IN
• Providers in East Chicago, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; 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.

Verify at the official NPI Registry.