Provider Demographics
NPI:1396950267
Name:RIOS, ELEONORE ANNA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ELEONORE
Middle Name:ANNA
Last Name:RIOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 E 84TH ST
Mailing Address - Street 2:APARTMENT 5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-6219
Mailing Address - Country:US
Mailing Address - Phone:121-273-7549
Mailing Address - Fax:
Practice Address - Street 1:415 E 84TH ST
Practice Address - Street 2:APARTMENT 5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-6219
Practice Address - Country:US
Practice Address - Phone:121-273-7549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021568-1 19781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY021568-1 1987OtherLICENSE NUMBER