Provider Demographics
NPI:1588458129
Name:RIVERO, NICOLE M (LMHC)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:RIVERO
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4322 SW 159TH PATH
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5311
Mailing Address - Country:US
Mailing Address - Phone:786-389-4614
Mailing Address - Fax:
Practice Address - Street 1:2555 NW 102ND AVE STE 217
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2131
Practice Address - Country:US
Practice Address - Phone:786-389-4614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23741101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health