Provider Demographics
NPI:1487229779
Name:RIVA, SARAH MARIE (PMHP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:RIVA
Suffix:
Gender:F
Credentials:PMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5217 S 28TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68107-3402
Mailing Address - Country:US
Mailing Address - Phone:402-715-5446
Mailing Address - Fax:
Practice Address - Street 1:5217 S 28TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68107-3402
Practice Address - Country:US
Practice Address - Phone:402-715-5446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12584101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health