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Individual
MS. RIVA XYLINA BENNETT
Active
Individual
MS. RIVA XYLINA BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, BCBA
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH 8627
FL
103K00000X
Behavior Analyst
Primary
1-08-4732
FL
103TS0200X
School Psychologist
00357584
NJ
103TS0200X
School Psychologist
1001170
FL
104100000X
Social Worker
SW 47601
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000531000
MEDICAID DD WAIVER PROVIDER
FL
01
—
000648800
MEDICAID DD WAIVER PROVIDER
FL
Enumeration date
03/14/2012
Last updated
12/05/2014
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