Rene Rivera, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

084687 Issued in NY

Practice address

3708 91St St Ste 300
Jackson Heights, NY 11372-7961

Phone

(718) 779-2263

Fax

(718) 277-0822

NPI assigned

Sep 21, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1669723375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W SUNRISE HWY # 1077",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811104",
            "telephone_number": "929-855-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 91ST ST STE 300",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727961",
            "telephone_number": "718-779-2263",
            "fax_number": "718-277-0822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "RENE",
        "credential": "LCSW-R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-21",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47-4278777",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rite Aid of New York Inc
• Rite Aid of New York Inc
• Francisco J Rivera Negron
• Amos Iolo Rivera
• Rebecca Rivera, PHD, LCSW-R
• Nelson Hiram Rivero, L.M.H.C.
• Christopher Rizzo, LMHC
• RJ Acuherbs LLC
• RJM Medical of Jackson Heights PC
• RJM Medical Services, P.C.

• Clinical Social Worker in Jackson Heights, NY
• Providers in Jackson Heights, 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 Oct 4, 2022; 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.