Provider Demographics
NPI:1700285319
Name:NIEVES, RAMON ANTONIO JR (LCSW)
Entity type:Individual
Prefix:MR
First Name:RAMON
Middle Name:ANTONIO
Last Name:NIEVES
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7 WEBSTER DR
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-2522
Mailing Address - Country:US
Mailing Address - Phone:203-751-3272
Mailing Address - Fax:
Practice Address - Street 1:1000 BRIDGEPORT AVE
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4660
Practice Address - Country:US
Practice Address - Phone:203-712-9998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CT0109821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)