Provider Demographics
NPI:1609397017
Name:RIVERS, JENNIFER (LCSW, LAC-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:RIVERS
Suffix:
Gender:F
Credentials:LCSW, LAC-C
Other - Prefix:
Other - First Name:JEN
Other - Middle Name:
Other - Last Name:SHIRILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1153
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-1153
Mailing Address - Country:US
Mailing Address - Phone:406-443-2343
Mailing Address - Fax:406-442-5490
Practice Address - Street 1:60 S LAST CHANCE GULCH
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4131
Practice Address - Country:US
Practice Address - Phone:406-443-2343
Practice Address - Fax:406-442-5490
Is Sole Proprietor?:No
Enumeration Date:2017-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT440191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical