Edwin Rivera Jr.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC014547 Issued in GA

Practice address

5050 Research CT Ste 800
Suwanee, GA 30024-6606

Phone

(678) 749-7600

NPI assigned

Feb 8, 2023

Last updated

Feb 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• 100 Percent Nutrition LLC

  • Health Service Clinic/Center
  • Gainesville, GA
  • NPI 1851909857
  NPD (past)
• Fresh Start for the Mind, LLC

  • Psychologist
  • Alpharetta, GA
  • NPI 1184966061
  NPD (past)

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

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1720785983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 RESEARCH CT STE 800",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246606",
            "telephone_number": "678-749-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5050 RESEARCH CT STE 800",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246606",
            "telephone_number": "678-749-7600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 Laurel Springs Pkwy Ste 802",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300246096",
            "country_code": "US",
            "telephone_number": "404-808-1161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "EDWIN",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-08",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "APC007538",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC014547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelynn Rickard, CCC-SLP
• Rise and Grow Therapy LLC
• Rise Mental Health LLC
• Rite Aid
• Donna Ritter, COUNSELOR
• RM Reasonerr
• Robert a Finkel DDS PC
• Robert D Shaffer (Psychology & Psychotherapy)
• Robert Douglas Clayton, MD. PC.
• Kamoy Roberts, RBT

• Professional Counselor in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.