Provider Demographics
NPI:1689446213
Name:ROBLEDO RIVERA, JAVIER (PSYD)
Entity Type:Individual
Prefix:
First Name:JAVIER
Middle Name:
Last Name:ROBLEDO RIVERA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COUNSELING AND PSYCHOLOGICAL SERVICES
Mailing Address - Street 2:225 CALHOUN ST, SUITE 200
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219
Mailing Address - Country:US
Mailing Address - Phone:513-556-0648
Mailing Address - Fax:513-556-2302
Practice Address - Street 1:COUNSELING AND PSYCHOLOGICAL SERVICES
Practice Address - Street 2:225 CALHOUN ST, SUITE 200
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219
Practice Address - Country:US
Practice Address - Phone:513-556-0648
Practice Address - Fax:513-556-2302
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.08480103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical