Provider Demographics
NPI:1760401301
Name:RIVERS, ERICA (LPC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:RIVERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2436 S INTERSTATE 35 E
Mailing Address - Street 2:STE 336
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4992
Mailing Address - Country:US
Mailing Address - Phone:940-484-1100
Mailing Address - Fax:940-484-7888
Practice Address - Street 1:2436 S INTERSTATE 35 E
Practice Address - Street 2:STE 336
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4992
Practice Address - Country:US
Practice Address - Phone:940-484-1100
Practice Address - Fax:940-484-7888
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19707101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional