| Rivers Psychotherapy Services, Llc | |
|
417 Security Sq Gulfport MS 39507-1922 | |
| (707) 728-5131 | |
| (855) 491-1093 |
| Full Name | Rivers Psychotherapy Services, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 417 Security Sq, Gulfport, Mississippi |
| Authorized Official Name and Position | Shelia Rivers (OWNER) |
| Authorized Official Contact | 7077285131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rivers Psychotherapy Services, Llc Po Box 255 Gulfport MS 39502-0255 Ph: (707) 728-5131 | Rivers Psychotherapy Services, Llc 417 Security Sq Gulfport MS 39507-1922 Ph: (707) 728-5131 |
| NPI Number | 1780115808 |
|---|---|
| Provider Enumeration Date | 03/21/2017 |
| Last Update Date | 11/11/2023 |
| Certification Date | 11/11/2023 |
| Medicare PECOS PAC ID | 6901182773 |
|---|---|
| Medicare Enrollment ID | O20170410000915 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780115808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | C8089 (Mississippi) | Secondary |
| Provider Name | Shelia Louise Rivers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003267444 PECOS PAC ID: 1456631100 Enrollment ID: I20161215000191 |
| Provider Name | Edward S Mcquilling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336532852 PECOS PAC ID: 7416200746 Enrollment ID: I20181102000370 |
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