Provider Demographics
NPI:1831401678
Name:RIVERA CARIDE, JESUS (MSW)
Entity type:Individual
Prefix:MR
First Name:JESUS
Middle Name:
Last Name:RIVERA CARIDE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10000
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00737-9601
Mailing Address - Country:US
Mailing Address - Phone:787-645-5413
Mailing Address - Fax:
Practice Address - Street 1:URB. ALTURA DEL PLATA
Practice Address - Street 2:C-25 PASEO DE LA COLINA
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00737-9601
Practice Address - Country:US
Practice Address - Phone:787-645-5413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0320101YA0400X
PR174441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)