Rivers Psychotherapy Services, LLC
Organization Active NPI Community/Behavioral Health Agency · Gulfport, MS
NPI 1780115808 · NPPES record last updated Aug 30, 2024
Key facts
- NPI
- 1780115808
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- C8089 (MS)
- Legal business name
- RIVERS PSYCHOTHERAPY SERVICES, LLC
- Practice address
- 417 Security SQ
Gulfport, MS 39507-1922 - Phone
- (707) 728-5131
- Fax
- (855) 491-1093
- NPI assigned
- Mar 21, 2017
- Organization subpart
- No
Authorized official
- Name
- Dr. Shelia Rivers, LCSW, MPH
- Title
- Owner
- Phone
- (707) 728-5131
Practitioners 4
-
Elisabeth Brownlee Faust, LCSW
-
Shelia Rivers, DSW, LCSW, MPH
-
Sanjuanita Arredondo, LMSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170410000915 | MS | Part B Supplier - Clinic/Group Practice | 6901182773 |
Receives reassigned benefits from 3 practitioners Practice locations: Gulfport, MS |
National Provider Directory
Locations
3422 Cleary Ave
Ste B
Metairie, LA 70002
Phone (504) 233-0118
417 Security Sq
Gulfport, MS 39507
Phone (707) 728-5131
2214 25th Ave
Ste 4
Gulfport, MS 39501
Phone (707) 728-5131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | C8089 | MS | Yes |
Addresses
Primary practice location
417 Security SQ
Gulfport, MS 39507-1922
Mailing address
PO Box 255
Gulfport, MS 39502-0255
Phone (707) 728-5131
Other practice location 1
3422 Cleary Ave Ste B
Metairie, LA 70002-8609
Phone (504) 233-0118
Other providers in Gulfport, MS
- Sarah Riley
- Miranda Rines
- Rebecca Ritchey
- River Psychology PLLC
- Wygelia Ann Rivera
- Shelia Rivers
- Robert J Weierman MD PLLC
- Barbara F. Roberts
- Charles Roberts
- Alex Robertson
All providers in Gulfport, MS · Community/Behavioral Health Agency in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.