Provider Demographics
NPI:1114582319
Name:RIVERA, KAREN RENEE' (LPC)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:RENEE'
Last Name:RIVERA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:KAREN
Other - Middle Name:RENEE'
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:4709 BRECKINRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3869
Mailing Address - Country:US
Mailing Address - Phone:972-679-3485
Mailing Address - Fax:972-238-8044
Practice Address - Street 1:550 S WATTERS RD STE 228
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5229
Practice Address - Country:US
Practice Address - Phone:972-679-3485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-03
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74595101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional