Provider Demographics
NPI:1104437995
Name:RIVERA, ERIKA LYNN (LMSW)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:LYNN
Last Name:RIVERA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1224 1ST ST S
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-3900
Mailing Address - Country:US
Mailing Address - Phone:208-322-5859
Mailing Address - Fax:
Practice Address - Street 1:1224 1ST ST S STE 307
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-3963
Practice Address - Country:US
Practice Address - Phone:208-322-5859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-39792104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker