Provider Demographics
NPI:1922725092
Name:NIEVES REYES, YARY E (MS, RMHCI)
Entity Type:Individual
Prefix:
First Name:YARY
Middle Name:E
Last Name:NIEVES REYES
Suffix:
Gender:F
Credentials:MS, RMHCI
Other - Prefix:
Other - First Name:YARY
Other - Middle Name:E
Other - Last Name:NIEVES REYES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, RMHCI
Mailing Address - Street 1:14495 CRAWFORD BROOK LN
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-1259
Mailing Address - Country:US
Mailing Address - Phone:561-657-1394
Mailing Address - Fax:561-473-9426
Practice Address - Street 1:1515 N FLAGLER DR STE 620
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3430
Practice Address - Country:US
Practice Address - Phone:844-665-4827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23446101YA0400X, 101YP2500X, 101YS0200X, 101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No171M00000XOther Service ProvidersCase Manager/Care Coordinator