Provider Demographics
NPI:1336369412
Name:NIEVES, RITA LUZ (RN, MPH, MSW)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:LUZ
Last Name:NIEVES
Suffix:
Gender:F
Credentials:RN, MPH, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 MASSACHUSETTS AVENUE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118
Mailing Address - Country:US
Mailing Address - Phone:617-534-2845
Mailing Address - Fax:
Practice Address - Street 1:1010 MASSACHUSETTS AVENUE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118
Practice Address - Country:US
Practice Address - Phone:617-534-2845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2151931041C0700X
MA170912163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)