Tammy J Rivera, LMSW

Individual provider Active NPI Clinical Social Worker · Bushkill, PA

NPI 1174772867 · NPPES record last updated Sep 17, 2008

Key facts

NPI
1174772867
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
060002 (NY)
Practice address
273 Ranchlands
Bushkill, PA 18324-8702
Phone
(570) 828-2388
Fax
(570) 828-2388
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
060002NYMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 060002 NY Yes

Addresses

Primary practice location

273 Ranchlands
Bushkill, PA 18324-8702

Mailing address

273 Ranchlands
Bushkill, PA 18324-8702
Phone (570) 828-2388

Other providers in Bushkill, PA

All providers in Bushkill, PA · Clinical Social Worker in Pennsylvania

Sources for this page

Verify at the official NPI Registry.