Healthcare Provider Details

I. General information

NPI: 1578325338
Provider Name (Legal Business Name): MONICA RIOS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2209 MARYLAND AVE
BALTIMORE MD
21218-5627
US

IV. Provider business mailing address

104 SANFORD PL
NEWARK NJ
07106-3316
US

V. Phone/Fax

Practice location:
  • Phone: 347-972-5221
  • Fax:
Mailing address:
  • Phone: 347-972-5221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number93212
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: