Provider Demographics
NPI:1457739187
Name:RIZZI, JOHN (PHD, LCSW)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:RIZZI
Suffix:
Gender:M
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 W END AVE
Mailing Address - Street 2:APT 15C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7343
Mailing Address - Country:US
Mailing Address - Phone:516-655-1025
Mailing Address - Fax:
Practice Address - Street 1:140 RIVERSIDE DR
Practice Address - Street 2:1-O
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2605
Practice Address - Country:US
Practice Address - Phone:516-655-1025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-14
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY08314211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical