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Individual

CARRIEBETH RIVAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHC, CASAC

Contact information

Practice address
391 WESTERN AVENUE, ALBANY, NY 12203
(518) 242-4731
(518) 242-4747
Mailing address
391 WESTERN AVENUE, ALBANY, NY 12203
(518) 242-4731
(518) 242-4747

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
004603
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02664359
NY
01
051104000053
FIDELIS
NY
Enumeration date
10/29/2010
Last updated
09/25/2013
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