Provider Demographics
NPI:1073795415
Name:RIVAS, DUARJI MALIEK (LICSW)
Entity Type:Individual
Prefix:
First Name:DUARJI
Middle Name:MALIEK
Last Name:RIVAS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 N PLEASANT ST STE 207
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1741
Mailing Address - Country:US
Mailing Address - Phone:413-461-4042
Mailing Address - Fax:413-726-6001
Practice Address - Street 1:48 N PLEASANT ST STE 207
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1741
Practice Address - Country:US
Practice Address - Phone:413-461-4042
Practice Address - Fax:413-726-6001
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1220051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical