Provider Demographics
NPI:1518672302
Name:RIVERS, TONI (LMSW)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:RIVERS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6814 CREST PL
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-4344
Mailing Address - Country:US
Mailing Address - Phone:850-525-0600
Mailing Address - Fax:
Practice Address - Street 1:6814 CREST PL
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-4344
Practice Address - Country:US
Practice Address - Phone:850-525-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker