Provider Demographics
NPI:1699515817
Name:AGUILAR DE RIVAS, MERY J (LCSW-C)
Entity type:Individual
Prefix:
First Name:MERY
Middle Name:J
Last Name:AGUILAR DE RIVAS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19241 ESMOND TER
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1576
Mailing Address - Country:US
Mailing Address - Phone:240-671-3843
Mailing Address - Fax:
Practice Address - Street 1:19241 ESMOND TER
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1576
Practice Address - Country:US
Practice Address - Phone:240-671-3843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD208401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical