Provider Demographics
NPI:1831521145
Name:DR NANCY M RIVAS PC FLOURISHING LIVES COUNSELING CENTER
Entity type:Organization
Organization Name:DR NANCY M RIVAS PC FLOURISHING LIVES COUNSELING CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIVAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:331-229-3123
Mailing Address - Street 1:1805 N MILL ST
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1275
Mailing Address - Country:US
Mailing Address - Phone:313-229-3123
Mailing Address - Fax:331-226-0780
Practice Address - Street 1:1805 N MILL ST STE L
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-4860
Practice Address - Country:US
Practice Address - Phone:630-881-6604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-09
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
IL071006321103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty