Individual provider Active NPI

Michelle Rivera, MFT PERMIT PENDING

  • Marriage & Family Therapist
  • Bronx, NY
National Provider Identifier
1770917080
Registry record updated Aug 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
579 Courtlandt Ave
Bronx, NY 10451-5013
Phone
(718) 485-2100
Fax
(718) 485-2101
NPI assigned
Aug 23, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

579 Courtlandt Ave
Bronx, NY 10451-5013

Mailing address

2154 Bruckner Blvd
Apt. 2
Bronx, NY 10473-1301
Phone (347) 398-0663

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

Practice roles

OrganizationSpecialtyStatusNew patients
New York Psychotherapy and Counseling Center PastSince Nov 5, 2015 Accepting new patients
Coordinated Behavioral Care Ipa Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377216000000",
    "number": "1770917080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2154 BRUCKNER BLVD",
            "address_2": "APT. 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104731301",
            "telephone_number": "347-398-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 COURTLANDT AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515013",
            "telephone_number": "718-485-2100",
            "fax_number": "718-485-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "MICHELLE",
        "credential": "MFT PERMIT PENDING",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-23",
        "last_updated": "2013-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2013; 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.