Provider Demographics
NPI:1063948032
Name:NECOLE RIVERS LLC
Entity type:Organization
Organization Name:NECOLE RIVERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PROVIDER/PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:NECOLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RIVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-338-3175
Mailing Address - Street 1:1506 DAVIS MILL LN
Mailing Address - Street 2:
Mailing Address - City:SALADO
Mailing Address - State:TX
Mailing Address - Zip Code:76571-5990
Mailing Address - Country:US
Mailing Address - Phone:254-338-3175
Mailing Address - Fax:254-265-7061
Practice Address - Street 1:1023 CANYON CREEK DR STE 100
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3278
Practice Address - Country:US
Practice Address - Phone:254-265-7822
Practice Address - Fax:254-265-7061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty