Provider Demographics
NPI:1033975040
Name:RIVERA, KIMBERLY OSCANOA (LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:OSCANOA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LEE AVE
Mailing Address - Street 2:
Mailing Address - City:HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-1224
Mailing Address - Country:US
Mailing Address - Phone:862-237-2267
Mailing Address - Fax:
Practice Address - Street 1:9 LEE AVE
Practice Address - Street 2:
Practice Address - City:HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-1224
Practice Address - Country:US
Practice Address - Phone:862-237-2267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC01008800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health