Provider Demographics
NPI:1447585815
Name:RIVERS, CELINE (FNP-C, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:CELINE
Middle Name:
Last Name:RIVERS
Suffix:
Gender:F
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 DOCTORS CT
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:SC
Mailing Address - Zip Code:29706-8644
Mailing Address - Country:US
Mailing Address - Phone:803-327-4198
Mailing Address - Fax:803-385-2440
Practice Address - Street 1:205 PIEDMONT BLVD STE 100
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1836
Practice Address - Country:US
Practice Address - Phone:803-327-2012
Practice Address - Fax:803-327-4198
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN.3998RX363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1592Medicaid
SCP01173514OtherRR-MEDICARE
SCAA99138798Medicare PIN