Provider Demographics
NPI:1760126858
Name:RIVADENEIRA, EVELYNN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:EVELYNN
Middle Name:
Last Name:RIVADENEIRA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2265 OAK SHADOW CT
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32766-7012
Mailing Address - Country:US
Mailing Address - Phone:407-756-4178
Mailing Address - Fax:
Practice Address - Street 1:800 WESTWOOD SQ STE B
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8849
Practice Address - Country:US
Practice Address - Phone:407-756-4178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT4357101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health