Provider Demographics
NPI:1952679110
Name:MARIA RIVERA HEATH LMFT, LLC
Entity Type:Organization
Organization Name:MARIA RIVERA HEATH LMFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RIVERA HEATH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-823-8476
Mailing Address - Street 1:388 EAST MAIN STREET
Mailing Address - Street 2:SUITE 19
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405
Mailing Address - Country:US
Mailing Address - Phone:203-823-8476
Mailing Address - Fax:
Practice Address - Street 1:388 EAST MAIN STREET
Practice Address - Street 2:SUITE 19
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405
Practice Address - Country:US
Practice Address - Phone:203-823-8476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001467106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty