Provider Demographics
NPI:1972620748
Name:RIVIN, ADRIEN SURVOL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ADRIEN
Middle Name:SURVOL
Last Name:RIVIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12319 VIEWCREST RD
Mailing Address - Street 2:
Mailing Address - City:STUDIO CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91604-3652
Mailing Address - Country:US
Mailing Address - Phone:818-505-9124
Mailing Address - Fax:
Practice Address - Street 1:14425 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-1713
Practice Address - Country:US
Practice Address - Phone:818-784-7107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS65031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical