MEDICARE: CASSANDRA RIVERA 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

General Provider Information

NPI Number	:	1518566652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA RIVERA LCSW

Provider Business Mailing Address
First Line	:	57 PLAINS RD STE 33
Second Line	:
City	:	MILFORD
State	:	CT
Zip	:	06461-2529
Country	:	US
Telephone Number	:	203-290-1717
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 PLAINS RD STE 33
Second Line	:
City	:	MILFORD
State	:	CT
Zip	:	06461-2529
Country	:	US
Telephone Number	:	32-901-7172
Fax Number	:

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

Provider Enumeration Date	:	10/20/2020
Last Update Date	:	04/01/2024

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Directions to “ CASSANDRA RIVERA LCSW” Practice Location

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