Provider Demographics
NPI:1588191365
Name:RIVERA THURMAN, MARISOL (LMSW)
Entity Type:Individual
Prefix:
First Name:MARISOL
Middle Name:
Last Name:RIVERA THURMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 THE PKWY
Mailing Address - Street 2:
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-4015
Mailing Address - Country:US
Mailing Address - Phone:914-439-2572
Mailing Address - Fax:
Practice Address - Street 1:60 PALMERS HILL RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2113
Practice Address - Country:US
Practice Address - Phone:203-324-3167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical