Provider Demographics
NPI:1508541996
Name:KRIVOR, KSENIA (MSW)
Entity Type:Individual
Prefix:
First Name:KSENIA
Middle Name:
Last Name:KRIVOR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:763 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-1105
Mailing Address - Country:US
Mailing Address - Phone:914-843-2243
Mailing Address - Fax:
Practice Address - Street 1:88 W RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3199
Practice Address - Country:US
Practice Address - Phone:914-843-2243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical