Provider Demographics
NPI:1386287985
Name:RIVERS, ANDREW GUY (LPC)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:GUY
Last Name:RIVERS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 CONSTITUTION DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3521
Mailing Address - Country:US
Mailing Address - Phone:318-704-0640
Mailing Address - Fax:318-704-0642
Practice Address - Street 1:108 CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3521
Practice Address - Country:US
Practice Address - Phone:318-704-0640
Practice Address - Fax:318-704-0642
Is Sole Proprietor?:No
Enumeration Date:2019-10-26
Last Update Date:2019-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7235101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional