Provider Demographics
NPI:1437506391
Name:RIVAS, MICHELE (LMHC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:RIVAS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 N COMMERCE PKWY
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3238
Mailing Address - Country:US
Mailing Address - Phone:631-455-1581
Mailing Address - Fax:
Practice Address - Street 1:2111 N COMMERCE PKWY
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3238
Practice Address - Country:US
Practice Address - Phone:631-455-1581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-20
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008420101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health