Provider Demographics
NPI:1992395776
Name:NIEVES HERNANDEZ, RICHARD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:NIEVES HERNANDEZ
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:HC 1 BOX 8054
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-7360
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:AVE. RAFAEL COLON CASTRO #3, URB. RADIOVILLE
Practice Address - Street 2:SUITE 2
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-2715
Practice Address - Country:US
Practice Address - Phone:939-244-7013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TA0400X, 103TP2701X
PR6529103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy