MEDICARE: ESTEBAN RIOS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	091425	NY

General Provider Information

NPI Number	:	1346790904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ESTEBAN RIOS LCSW

Provider Business Mailing Address
First Line	:	825 MORRISON AVE APT 7G
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10473-4439
Country	:	US
Telephone Number	:	646-207-2641
Fax Number	:

Provider Business Practice Location Address
First Line	:	825 MORRISON AVE
Second Line	:	7G
City	:	BRONX
State	:	NY
Zip	:	10473-4443
Country	:	US
Telephone Number	:	646-207-2641
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2016
Last Update Date	:	12/01/2025

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