Provider Demographics
NPI:1093974339
Name:RIVINSON, ASYA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ASYA
Middle Name:
Last Name:RIVINSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ASYA
Other - Middle Name:
Other - Last Name:VOLBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:96 ELM ST
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-2112
Mailing Address - Country:US
Mailing Address - Phone:800-870-6244
Mailing Address - Fax:
Practice Address - Street 1:697 VALLEY ST
Practice Address - Street 2:SUITE B1
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2641
Practice Address - Country:US
Practice Address - Phone:800-870-6244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2017-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079083-11041C0700X
NJ44SC056479001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical