Basic Information
Provider Information
NPI: 1881087708
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RIVERA
FirstName: ESTHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSW, LAC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4141 E DICKENSON PL
Address2:  
City: DENVER
State: CO
PostalCode: 802226012
CountryCode: US
TelephoneNumber: 3035046500
FaxNumber: 3037829612
Practice Location
Address1: 11059 E BETHANY DR
Address2:  
City: AURORA
State: CO
PostalCode: 800142622
CountryCode: US
TelephoneNumber: 3036172300
FaxNumber: 3036172365
Other Information
ProviderEnumerationDate: 03/17/2015
LastUpdateDate: 10/31/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/31/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
171M00000X  N Other Service ProvidersCase Manager/Care Coordinator 
101YA0400XACD.0002152COY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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