Provider Demographics
NPI:1306945837
Name:RIVERA, MARIA PILAR (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:PILAR
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:MS
Other - First Name:M
Other - Middle Name:PILAR
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:643 S. BIRDSONG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258
Mailing Address - Country:US
Mailing Address - Phone:210-355-4727
Mailing Address - Fax:210-257-6560
Practice Address - Street 1:7272 WURZBACH ROAD
Practice Address - Street 2:SUITE 1504
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240
Practice Address - Country:US
Practice Address - Phone:210-647-7707
Practice Address - Fax:210-647-7805
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15887101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX028584301Medicaid