Kerry Rivera, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

098466-01 Issued in NY

Practice address

631 Montauk Hwy Ste 9
West Islip, NY 11795-4400

Phone

(631) 319-9512

NPI assigned

Dec 28, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1073100897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BARBERRY RD",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117953910",
            "telephone_number": "631-793-3435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 MONTAUK HWY STE 9",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954400",
            "telephone_number": "631-319-9512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "296 N Main St",
            "address_purpose": "LOCATION",
            "city": "Sayville",
            "state": "NY",
            "postal_code": "117822550",
            "country_code": "US",
            "telephone_number": "631-472-2629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "KERRY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-28",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "056611-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "098466-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Sayville",
            "affiliation": "N",
            "address_1": "296 N Main St",
            "city": "Sayville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117822550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mahum Inam Riaz
• Omer Richman
• Liam C Riddle, GENETIC COUNSELOR
• Matthew David Rifkin, MD
• Loretta Ann Rispoli, NP
• Caroline Dorothy Rizea, DO
• Robert Sidney Schwartz M.D., PLLC
• Christine Karen Robles, D.O.
• Jenier Rodriguez
• Delia Rogu, MD

• Clinical Social Worker in West Islip, NY
• Providers in West Islip, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.