Provider Demographics
NPI:1679069454
Name:LARIVEE, RAYMOND (LCSW)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:LARIVEE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2144 SUN SWEPT WAY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-4261
Mailing Address - Country:US
Mailing Address - Phone:702-336-0699
Mailing Address - Fax:
Practice Address - Street 1:1785 E SAHARA AVE STE 145
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-3713
Practice Address - Country:US
Practice Address - Phone:702-486-4349
Practice Address - Fax:702-486-6408
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9934-C1041C0700X
NV7066-S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker