Provider Demographics
NPI:1376574822
Name:RIVERA, LUISA ESPERANZA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LUISA
Middle Name:ESPERANZA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1779 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3635
Mailing Address - Country:US
Mailing Address - Phone:212-534-4432
Mailing Address - Fax:212-387-7432
Practice Address - Street 1:540 E 13TH STREET
Practice Address - Street 2:ROBERTO CLEMENTE CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009
Practice Address - Country:US
Practice Address - Phone:212-387-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0531241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN696R1Medicare PIN