Provider Demographics
NPI:1497472823
Name:RIVERA, CYNTHIA SOPHIA (LPC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:SOPHIA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2556 HESSING ST
Mailing Address - Street 2:
Mailing Address - City:RIVER GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60171-1728
Mailing Address - Country:US
Mailing Address - Phone:773-551-4827
Mailing Address - Fax:
Practice Address - Street 1:1550 S INDIANA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2857
Practice Address - Country:US
Practice Address - Phone:773-377-5577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor