Provider Demographics
NPI:1245057702
Name:RIVERA, GINGER (BSW)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 BLUE JAY WAY
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-9060
Mailing Address - Country:US
Mailing Address - Phone:719-641-8640
Mailing Address - Fax:
Practice Address - Street 1:3555 STANFORD RD STE 140
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4680
Practice Address - Country:US
Practice Address - Phone:970-829-1128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical