Provider Demographics
NPI:1144531054
Name:RIVAS, BITA ASHOURI (EDD, LPC, NCC)
Entity type:Individual
Prefix:DR
First Name:BITA
Middle Name:ASHOURI
Last Name:RIVAS
Suffix:
Gender:F
Credentials:EDD, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2163 N ACADEMY BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1507
Mailing Address - Country:US
Mailing Address - Phone:303-217-3732
Mailing Address - Fax:719-418-2770
Practice Address - Street 1:2163 N ACADEMY BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-1507
Practice Address - Country:US
Practice Address - Phone:303-217-3732
Practice Address - Fax:719-418-2770
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X, 101YP2500X
CO11298101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health