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General NPI Number Information
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NPI Number | 1518260298
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Entity Type | Individual
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Provider Name | IRMA RIVERA L.M.H.C.
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Gender | Female
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Dates
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Enumeration Date | 12/17/2010
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Last Update Date | 12/17/2010
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Provider Practice Location Address
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Address Line | 1 GUSTAVE L LEVY PL BOX 1268
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City | NEW YORK
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State | NY
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Zip | 10029-6500
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Country | US
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Telephone | 212-987-7214
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Fax |
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Provider Business Mailing Address
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Address Line | 3951 GOUVERNEUR AVE APT. 4K
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City | BRONX
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State | NY
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Zip | 10463-2904
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Country | US
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Telephone | 917-612-4593
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 003809
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License Number State | NY
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