Provider Demographics
NPI:1023547106
Name:RIVIERA, SARA (PLMHP,PMSW)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:RIVIERA
Suffix:
Gender:F
Credentials:PLMHP,PMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 CUMING ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2000
Mailing Address - Country:US
Mailing Address - Phone:531-299-0220
Mailing Address - Fax:
Practice Address - Street 1:8210 S 42ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68147-1705
Practice Address - Country:US
Practice Address - Phone:531-299-2313
Practice Address - Fax:531-299-2319
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE104100000X, 1041S0200X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool