Provider Demographics
NPI:1275182990
Name:RIVERA, LUCELENIA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LUCELENIA
Middle Name:
Last Name:RIVERA
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:LUCELENIA
Other - Middle Name:
Other - Last Name:MORALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:388 OLIVER RD
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:CT
Mailing Address - Zip Code:06249-1620
Mailing Address - Country:US
Mailing Address - Phone:860-942-3667
Mailing Address - Fax:
Practice Address - Street 1:322 MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-3152
Practice Address - Country:US
Practice Address - Phone:860-450-2000
Practice Address - Fax:860-639-3827
Is Sole Proprietor?:No
Enumeration Date:2019-09-05
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT107551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical