Provider Demographics
NPI:1134287402
Name:RIVERA, JULIAN J (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JULIAN
Middle Name:J
Last Name:RIVERA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 LINVINGSTON ST
Mailing Address - Street 2:PHF
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5031
Mailing Address - Country:US
Mailing Address - Phone:718-596-1791
Mailing Address - Fax:
Practice Address - Street 1:OCNI 3764 72ND ST
Practice Address - Street 2:
Practice Address - City:JACKSON HTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6143
Practice Address - Country:US
Practice Address - Phone:718-335-3434
Practice Address - Fax:718-335-4731
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0455791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical