Provider Demographics
NPI:1174810147
Name:RIVERA, AKEISHA LA TOYA (PSYD)
Entity type:Individual
Prefix:MS
First Name:AKEISHA
Middle Name:LA TOYA
Last Name:RIVERA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:MS
Other - First Name:AKEISHA
Other - Middle Name:LA TOYA
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34 RAMONA RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-7010
Mailing Address - Country:US
Mailing Address - Phone:720-425-1321
Mailing Address - Fax:
Practice Address - Street 1:800 WESTCHESTER AVE STE N641
Practice Address - Street 2:
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573
Practice Address - Country:US
Practice Address - Phone:914-231-0362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020809103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical