Provider Demographics
NPI:1114140944
Name:RIVERA LASSEN, ADNEIDA AMERICA (MS)
Entity Type:Individual
Prefix:MS
First Name:ADNEIDA
Middle Name:AMERICA
Last Name:RIVERA LASSEN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 MAPLE ST
Mailing Address - Street 2:SUITE 219
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103
Mailing Address - Country:US
Mailing Address - Phone:413-737-3730
Mailing Address - Fax:413-731-7381
Practice Address - Street 1:120 MAPLE ST
Practice Address - Street 2:SUITE 219
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103
Practice Address - Country:US
Practice Address - Phone:413-737-3730
Practice Address - Fax:413-731-7381
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical