Sandra D Rivera, LPC IT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3423-226 Issued in WI

Practice address

130 E Walnut St
Suite 706
Green Bay, WI 54301-4239

Phone

(920) 437-8256

Fax

(920) 437-1188

NPI assigned

Sep 27, 2016

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

Practice roles

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.

• Foundations Health and Wholeness Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Green Bay, WI
  • NPI 1497840607
  NPD (past)

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

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1982153318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E WALNUT ST",
            "address_2": "SUITE 706",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E WALNUT ST",
            "address_2": "SUITE 706",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543014239",
            "telephone_number": "920-437-8256",
            "fax_number": "920-437-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "SANDRA",
        "middle_name": "D",
        "credential": "LPC IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "3423-226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex W Ritchay, MD
• Megan Ritchay, PHD
• Samantha F Ritchie, MA
• Shelley Riutta, MSE
• Shiloe Elaine Rivas
• Shelby A. Robbins, CSAC
• Teresa A Robbins, LPC, CSAC
• Robert H Wagner Family Dentist S.C.
• Ashley J Roberts, OTR
• Audrey Roberts

• Mental Health Counselor in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; 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.