Individual
LISA RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC, LAC
Contact information
Practice address
1225 KEN PRATT BLVD, STE. 200, LONGMONT, CO 80501-6518
(303) 772-3382
Mailing address
1225 KEN PRATT BLVD, STE. 200, LONGMONT, CO 80501-6518
(303) 772-3382
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC0011444
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD0000527
CO
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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