Active NPI
Gloria Rivera King, PH.D., M.A.
- Marriage & Family Therapist
- Melbourne, FL
National Provider Identifier
1871622894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MT1771
- Practice address
- 109 Silver Palm Ave
Melbourne, FL 32901-3125 - Phone
- (321) 506-8373
- Fax
- (321) 956-1502
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MH5380 | FL | |
| Marriage & Family Therapist | 106H00000X | MT1771 | FL | Primary |
Addresses
Primary practice location
109 Silver Palm Ave
Melbourne, FL 32901-3125
Mailing address
109 Silver Palm Ave
Melbourne, FL 32901-3125
Phone (321) 506-8373
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 16, 2024 through Oct 16, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH5380 | FL | MD | Mental Health Counselor |
| MT1771 | FL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201737600000",
"number": "1871622894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 SILVER PALM AVE",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013125",
"telephone_number": "321-506-8373",
"fax_number": "321-956-1502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 SILVER PALM AVE",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329013125",
"telephone_number": "321-506-8373",
"fax_number": "321-956-1502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "GLORIA",
"middle_name": "RIVERA",
"credential": "PH.D., M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2008-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "MH5380",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "MT1771",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.