Provider Demographics
NPI:1487175204
Name:RIVERA, DESIRE (MA COUNSELING)
Entity type:Individual
Prefix:
First Name:DESIRE
Middle Name:
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MA COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 EXCHANGE ST
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01013-1679
Mailing Address - Country:US
Mailing Address - Phone:413-437-9159
Mailing Address - Fax:
Practice Address - Street 1:249 EXCHANGE ST
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01013-1679
Practice Address - Country:US
Practice Address - Phone:413-594-2141
Practice Address - Fax:413-540-5081
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-01
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health