Provider Demographics
NPI:1588122121
Name:DR. YESENIA COLON RIVERA, PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:DR. YESENIA COLON RIVERA, PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:YESENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:877-607-8945
Mailing Address - Street 1:1820 QUENTIN RD # 1029
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7436
Mailing Address - Country:US
Mailing Address - Phone:877-607-8945
Mailing Address - Fax:877-387-1188
Practice Address - Street 1:701 CUMBERLAND ST STE 205
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-5231
Practice Address - Country:US
Practice Address - Phone:877-607-8945
Practice Address - Fax:877-387-1188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-02
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty