Kimberly Watterson-Rivieccio

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH20967 Issued in FL

Practice address

1003 W Indiantown Rd Ste 213
Jupiter, FL 33458-6853

Phone

(561) 351-4683

NPI assigned

Jul 22, 2022

Last updated

May 6, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Els for Autism Foundation

  • Behavior Analyst
  • Jupiter, FL
  • NPI 1336522515

  Mental Health

  NPD

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1811622889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 LUCIA CT",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334785471",
            "telephone_number": "561-351-4683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 W INDIANTOWN RD STE 213",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334586853",
            "telephone_number": "561-351-4683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18370 Limestone Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "334583860",
            "country_code": "US",
            "telephone_number": "561-598-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATTERSON-RIVIECCIO",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-22",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH20967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kelly Ann Weaver, RN, MSN, FNP, ARNP-C
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• Susan Webster, OTR/L
• Ellen Lynn Weinberg, AU.D.

• Mental Health Counselor in Jupiter, FL
• Providers in Jupiter, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.