Provider Demographics
NPI:1346790904
Name:RIOS, ESTEBAN (LMSW)
Entity Type:Individual
Prefix:
First Name:ESTEBAN
Middle Name:
Last Name:RIOS
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 1:825 MORRISON AVE
Mailing Address - Street 2:7G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-4443
Mailing Address - Country:US
Mailing Address - Phone:646-207-2641
Mailing Address - Fax:
Practice Address - Street 1:825 MORRISON AVE
Practice Address - Street 2:7G
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-4443
Practice Address - Country:US
Practice Address - Phone:646-207-2641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0876841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical