Provider Demographics
NPI:1851569198
Name:NIEVES RIVERA, MARIELY (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARIELY
Middle Name:
Last Name:NIEVES RIVERA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB RIVER EDGE HILLS 61 CALLE RIO SABANA
Mailing Address - Street 2:
Mailing Address - City:LUQUILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00773
Mailing Address - Country:US
Mailing Address - Phone:939-287-6776
Mailing Address - Fax:
Practice Address - Street 1:CENTRO COMERCIAL PLAZA LAS BRISAS LOCAL #5
Practice Address - Street 2:URB. MONTE BRISAS
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:939-287-6776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3015103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical