Provider Demographics
NPI:1669015004
Name:MENDEZ RIVERA, KARINA PAOLA
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:PAOLA
Last Name:MENDEZ RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 PARK AVE STE 804
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1984
Mailing Address - Country:US
Mailing Address - Phone:508-756-5400
Mailing Address - Fax:508-756-5400
Practice Address - Street 1:255 PARK AVE STE 804
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1984
Practice Address - Country:US
Practice Address - Phone:508-756-5400
Practice Address - Fax:508-756-5433
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health