Provider Demographics
NPI:1386364396
Name:RIVERA CRUZ, NORELYS MARIE (CSW)
Entity type:Individual
Prefix:
First Name:NORELYS
Middle Name:MARIE
Last Name:RIVERA CRUZ
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. COLINAS VERDE AZUL
Mailing Address - Street 2:#14 CALLE ARREZO
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795
Mailing Address - Country:US
Mailing Address - Phone:939-243-6157
Mailing Address - Fax:
Practice Address - Street 1:URB. COLINAS VERDE AZUL
Practice Address - Street 2:#14 CALLE ARREZO
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795
Practice Address - Country:US
Practice Address - Phone:939-243-6157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-30
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR157491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty