Provider Demographics
NPI:1881810133
Name:RIVARD, KERRY ANN (LMHC)
Entity type:Individual
Prefix:MRS
First Name:KERRY
Middle Name:ANN
Last Name:RIVARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:KERRY
Other - Middle Name:ANN
Other - Last Name:FRITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:44 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3022
Mailing Address - Country:US
Mailing Address - Phone:978-304-0006
Mailing Address - Fax:978-745-7772
Practice Address - Street 1:10 LIBERTY ST STE 117
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-2577
Practice Address - Country:US
Practice Address - Phone:978-387-5975
Practice Address - Fax:978-745-7772
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5065101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health