Individual
BRIDGETT RIVERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC-S, LICDC
Contact information
Practice address
202 EAST SAFFLE AVENUE, SYCAMORE, OH 44882-0362
(419) 934-2214
Mailing address
PO BOX 362, SYCAMORE, OH 44882-0362
(419) 721-1810
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C1400098
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
111130
OH
101YP2500X
Professional Counselor
Primary
E.2001602-SUPV
OH
Other
Enumeration date
02/10/2016
Last updated
09/12/2023
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