Provider Demographics
NPI:1952432890
Name:RIVERA, YOLANDA (LMHC)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BERARD CIR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01128-1004
Mailing Address - Country:US
Mailing Address - Phone:413-221-0645
Mailing Address - Fax:
Practice Address - Street 1:14 BERARD CIR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01128-1004
Practice Address - Country:US
Practice Address - Phone:413-221-0645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8639101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health