Provider Demographics
NPI:1376160515
Name:RIVES, ABIGAIL HARDY (LCSW)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:HARDY
Last Name:RIVES
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 1:4800 NW CLIFF VIEW DR APT 402
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:MO
Mailing Address - Zip Code:64150-1207
Mailing Address - Country:US
Mailing Address - Phone:816-267-3090
Mailing Address - Fax:
Practice Address - Street 1:4800 NW CLIFF VIEW DR APT 402
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:MO
Practice Address - Zip Code:64150-1207
Practice Address - Country:US
Practice Address - Phone:816-267-3090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-04
Last Update Date:2020-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190303661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical