Provider Demographics
NPI:1598582942
Name:RIVERA-MAGDA, CHRISTIANA LYNN (LPCA)
Entity type:Individual
Prefix:
First Name:CHRISTIANA
Middle Name:LYNN
Last Name:RIVERA-MAGDA
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-4729
Mailing Address - Country:US
Mailing Address - Phone:203-954-7785
Mailing Address - Fax:
Practice Address - Street 1:828 FEDERAL RD STE B
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-1847
Practice Address - Country:US
Practice Address - Phone:800-611-0185
Practice Address - Fax:800-930-5241
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional