Provider Demographics
NPI:1619396009
Name:LOZANO-RIVERA, JENNY PATRICIA (LCSW)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:PATRICIA
Last Name:LOZANO-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 1:574 67TH ST
Mailing Address - Street 2:APT. 2
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-1747
Mailing Address - Country:US
Mailing Address - Phone:973-985-9461
Mailing Address - Fax:
Practice Address - Street 1:574 67TH ST
Practice Address - Street 2:APT. 2
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-1747
Practice Address - Country:US
Practice Address - Phone:973-985-9461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055502001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical