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General NPI Number Information
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NPI Number | 1225644883
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Entity Type | Individual
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Provider Name | RICARDO DESHAWN RIVERA LICSW, LCSW-C
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Gender | Male
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Dates
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Enumeration Date | 09/18/2020
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Last Update Date | 07/26/2025
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Provider Practice Location Address
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Address Line | 6515 BELCREST RD
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City | HYATTSVILLE
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State | MD
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Zip | 20782-2010
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Country | US
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Telephone | 862-237-8738
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Fax |
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Provider Business Mailing Address
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Address Line | 921 CASLON WAY APT 207
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City | HYATTSVILLE
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State | MD
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Zip | 20785-6004
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Country | US
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Telephone | 862-237-8738
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC200002714
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 25865
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License Number State | MD
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