Provider Demographics
NPI:1245887223
Name:RIVERA, CARLA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 S COLLEGE RD # 1036
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1632
Mailing Address - Country:US
Mailing Address - Phone:910-442-8334
Mailing Address - Fax:
Practice Address - Street 1:7404 NORTON CT
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-7127
Practice Address - Country:US
Practice Address - Phone:910-987-9649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-23
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0136921041C0700X
NCC0150351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical