Provider Demographics
NPI:1447716816
Name:RIVES, VIRGINIA LEE (LPC)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:LEE
Last Name:RIVES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 OFFICE PARK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2435
Mailing Address - Country:US
Mailing Address - Phone:205-908-4894
Mailing Address - Fax:
Practice Address - Street 1:402 OFFICE PARK DR STE 101
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-2435
Practice Address - Country:US
Practice Address - Phone:205-908-4894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4490101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL198068Medicaid