Provider Demographics
NPI:1205699378
Name:RIVADENEIRA ORTIZ, JOSSY D (LCSW)
Entity type:Individual
Prefix:
First Name:JOSSY
Middle Name:D
Last Name:RIVADENEIRA ORTIZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JOSSY
Other - Middle Name:D
Other - Last Name:RIVADENEIRA ORTIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:8264 MARITIME FLAG ST UNIT 1416
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-5531
Mailing Address - Country:US
Mailing Address - Phone:631-384-0990
Mailing Address - Fax:
Practice Address - Street 1:8264 MARITIME FLAG ST UNIT 1416
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-5531
Practice Address - Country:US
Practice Address - Phone:631-384-0990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW225521041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical