Provider Demographics
NPI:1346839065
Name:BIVENS, RAHISHA ADRION (LCSW)
Entity Type:Individual
Prefix:MS
First Name:RAHISHA
Middle Name:ADRION
Last Name:BIVENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 QUINNIPIAC AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06513-4092
Mailing Address - Country:US
Mailing Address - Phone:860-538-2697
Mailing Address - Fax:
Practice Address - Street 1:715 QUINNIPIAC AVE APT 1
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06513-4092
Practice Address - Country:US
Practice Address - Phone:860-538-2697
Practice Address - Fax:860-499-3159
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-16
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11266101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health