Provider Demographics
NPI:1619417680
Name:RIVERA, MARIA VIRGINIA (LMSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:VIRGINIA
Last Name:RIVERA
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 1:165 W 197TH ST
Mailing Address - Street 2:APT 4K
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-2105
Mailing Address - Country:US
Mailing Address - Phone:610-705-2705
Mailing Address - Fax:
Practice Address - Street 1:302 W 91ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-1011
Practice Address - Country:US
Practice Address - Phone:212-787-7120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker