Provider Demographics
NPI:1982982963
Name:RIVERS, ANTHONY (PSYD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:RIVERS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3244 HENDERSON RD STE 4
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-7300
Mailing Address - Country:US
Mailing Address - Phone:614-664-3175
Mailing Address - Fax:614-386-1692
Practice Address - Street 1:3244 HENDERSON RD STE 4
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-7300
Practice Address - Country:US
Practice Address - Phone:614-664-3175
Practice Address - Fax:614-386-1692
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6935103TC0700X
OH103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical