| Ian Hugh Adon Rivera, LCSW, MCAP | |
| 
					1047 E Brandon Blvd, Brandon, FL 33511-5515  | |
| (414) 312-1010 | |
| Not Available | 
| Full Name | Ian Hugh Adon Rivera | 
|---|---|
| Gender | Male | 
| Speciality | Social Worker - Clinical | 
| Location | 1047 E Brandon Blvd, Brandon, Florida | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1164061040 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW17093 (Florida) | Primary | 
| Entity Name | Brandon Mental Health | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1649421389 PECOS PAC ID: 8527136977 Enrollment ID: O20081013000083  | 
| Entity Name | Total Life Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1053909267 PECOS PAC ID: 8123433034 Enrollment ID: O20210225003311  | 
| Entity Name | Grow Healthcare Group Pa | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20210414000053  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Ian Hugh Adon Rivera, LCSW, MCAP 12745 Lemon Pepper Dr, Riverview, FL 33578-7585 Ph: (414) 312-1010  | Ian Hugh Adon Rivera, LCSW, MCAP 1047 E Brandon Blvd, Brandon, FL 33511-5515 Ph: (414) 312-1010  | 
Kelsey Paterson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 126 Lithia Pinecrest Rd, Brandon, FL 33511 Phone: 813-689-8828  | |
Mr. Michael J Mazucci-mambala, L.C.S.W. Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 510 Vonderburg Dr, Suite 301, Brandon, FL 33511 Phone: 813-881-1000  | |
Ms. Cynthia Anne Fletcher, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 413 Ashford Dr, Brandon, FL 33511 Phone: 813-662-3441  | |
Michelle Ramirez, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 126 Lithia Pinecrest Rd, Brandon, FL 33511 Phone: 813-689-8828  | |
Karen Seales,  Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1419 Lake Lucerne Way, Brandon, FL 33511 Phone: 813-219-4551  | |
Brittany Wilson, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 126 Lithia Pinecrest Rd, Brandon, FL 33511 Phone: 813-689-8828 Fax: 813-689-8802  | |
Garrett Griffith, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1032 E Brandon Blvd # 7553, Brandon, FL 33511 Phone: 850-890-7553  |