Provider Demographics
NPI:1114337813
Name:RIVERA, GEMMA (LCPC , LMFT, LCADC)
Entity Type:Individual
Prefix:
First Name:GEMMA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:LCPC , LMFT, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 SAINT ROSE PKWY STE 221
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7789
Mailing Address - Country:US
Mailing Address - Phone:702-376-5842
Mailing Address - Fax:
Practice Address - Street 1:2520 SAINT ROSE PKWY STE 221
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7789
Practice Address - Country:US
Practice Address - Phone:702-376-5842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00446-LC101YA0400X
NVCP0233101YM0800X
NV01488106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health