Provider Demographics
NPI:1669082038
Name:RIVERA, DANIELLE D (LMSW)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:D
Last Name:RIVERA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:D
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:207 LAKE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10537-1344
Mailing Address - Country:US
Mailing Address - Phone:646-629-4636
Mailing Address - Fax:
Practice Address - Street 1:207 LAKE DR
Practice Address - Street 2:
Practice Address - City:LAKE PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10537-1344
Practice Address - Country:US
Practice Address - Phone:646-629-4636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-31
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078386104100000X
NY0974801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker