Provider Demographics
NPI:1336792175
Name:RIVERA, RAMON A JR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RAMON
Middle Name:A
Last Name:RIVERA
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY DR C - 122G
Mailing Address - Street 2:4100 ALLEQUIPPA ST
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15240
Mailing Address - Country:US
Mailing Address - Phone:412-822-2364
Mailing Address - Fax:
Practice Address - Street 1:1010 DELAFIELD RD RM 2A122
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15240-1005
Practice Address - Country:US
Practice Address - Phone:412-822-2412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-22
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW133235104100000X
PACW0219821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker