Provider Demographics
NPI:1003388018
Name:LARIVEE, ADAM
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:LARIVEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4513 BEECHWOOD LAKE DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-5263
Mailing Address - Country:US
Mailing Address - Phone:413-552-9217
Mailing Address - Fax:
Practice Address - Street 1:944 COUNTRY CLUB BLVD STE 208
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-3011
Practice Address - Country:US
Practice Address - Phone:239-273-0270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical