Provider Demographics
NPI:1710141882
Name:RIVERS, LATASHA RENE (DSW, LISW-CP)
Entity Type:Individual
Prefix:
First Name:LATASHA
Middle Name:RENE
Last Name:RIVERS
Suffix:
Gender:F
Credentials:DSW, LISW-CP
Other - Prefix:
Other - First Name:LATASHA
Other - Middle Name:RENE
Other - Last Name:HIGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SW
Mailing Address - Street 1:250 GLENIS DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-5160
Mailing Address - Country:US
Mailing Address - Phone:615-225-5815
Mailing Address - Fax:
Practice Address - Street 1:3400 LEBANON RD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1392
Practice Address - Country:US
Practice Address - Phone:615-867-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC69731041C0700X
TNLSW00000066181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical