Provider Demographics
NPI:1588459879
Name:RIVERA, CARLOS MOSES
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:MOSES
Last Name:RIVERA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:MOSES
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4455 E 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-2415
Mailing Address - Country:US
Mailing Address - Phone:303-504-7900
Mailing Address - Fax:
Practice Address - Street 1:2600 S GRANT ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5708
Practice Address - Country:US
Practice Address - Phone:303-733-9348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor