Provider Demographics
NPI:1063620359
Name:RIVERS, NELIA H (LCSW)
Entity type:Individual
Prefix:MS
First Name:NELIA
Middle Name:H
Last Name:RIVERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 DARLINGTON CIR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2707
Mailing Address - Country:US
Mailing Address - Phone:404-233-7360
Mailing Address - Fax:404-233-7360
Practice Address - Street 1:736 DARLINGTON CIR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2707
Practice Address - Country:US
Practice Address - Phone:404-233-7360
Practice Address - Fax:404-233-7360
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0002241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical