Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 6301015252 | MI |
N | 102L00000X | Psychologist | 6301015252 | MI |
N | 103T00000X | Psychologist | 6301015252 | MI |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 6301015252 | MI |
Y | 103G00000X | Clinical Psychologist | 6301015252 | MI |
Y | 103TC0700X | Clinical Psychologist | 6301015252 | MI |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 6301015252 | MI |
N | 103TM1800X | Intellectual & Developmental Disabilities | 6301015252 | MI |
N | 103TP2701X | Group Psychotherapist | 6301015252 | MI |
N | 103TS0200X | School Psychologist | 179302 | MI |
N | 104100000X | Social Worker | 6801013804 | MI |
N | 1041C0700X | Clinical Social Worker | 6801013804 | MI |
NPI | 1205271822 |
---|---|
Provider Name | Dr. Patrick David Rivard |
First Address | Sterling Heights, MI 48314-1627 |
Second Address | Sterling Heights, MI 48314-1627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2013 |
Last Update Date | 09/05/2013 |