Provider Demographics
NPI: | 1922394501 |
---|---|
Name: | RIOS, FAITH L (LCSW-A, LCAS-A) |
Entity Type: | Individual |
Prefix: | MRS |
First Name: | FAITH |
Middle Name: | L |
Last Name: | RIOS |
Suffix: | |
Gender: | F |
Credentials: | LCSW-A, LCAS-A |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 327 1ST AVE NW |
Mailing Address - Street 2: | |
Mailing Address - City: | HICKORY |
Mailing Address - State: | NC |
Mailing Address - Zip Code: | 28601-6122 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 828-695-5900 |
Mailing Address - Fax: | 828-695-4256 |
Practice Address - Street 1: | 327 1ST AVE NW |
Practice Address - Street 2: | |
Practice Address - City: | HICKORY |
Practice Address - State: | NC |
Practice Address - Zip Code: | 28601-6122 |
Practice Address - Country: | US |
Practice Address - Phone: | 828-695-5900 |
Practice Address - Fax: | 828-695-4256 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2011-06-22 |
Last Update Date: | 2019-03-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NC | LCAS-23648 | 101YA0400X |
NY | 083176 | 104100000X |
NC | P012894 | 1041C0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker |