Active NPI
Jean L Rivera, LICSW, CADCI
- Clinical Social Worker
- Tacoma, WA
National Provider Identifier
1902292428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW60592040
- Practice address
- 9040 Jackson Ave
Tacoma, WA 98431-1100 - Phone
- (253) 968-4836
- Fax
- (253) 968-3731
- NPI assigned
- Apr 10, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW60592040 | WA | Primary |
Addresses
Primary practice location
9040 Jackson Ave
Tacoma, WA 98431-1100
Mailing address
BLDG 9920a East Johnson St
Denali Embedded Behavioral Health Clinic
Joint Base Lewis-McChord, WA 98431-1100
Phone (253) 968-4836
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW60592040 | WA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552262400000",
"number": "1902292428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BLDG 9920A EAST JOHNSON ST",
"address_2": "DENALI EMBEDDED BEHAVIORAL HEALTH CLINIC",
"city": "JOINT BASE LEWIS-MCCHORD",
"state": "WA",
"postal_code": "984311100",
"telephone_number": "253-968-4836",
"fax_number": "253-968-3731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984311100",
"telephone_number": "253-968-4836",
"fax_number": "253-968-3731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVERA",
"first_name": "JEAN",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "LICSW, CADCI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-10",
"last_updated": "2019-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW60592040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.