Provider Demographics
NPI:1780366641
Name:RUBILAR-RIVERA, YERIELIS
Entity type:Individual
Prefix:
First Name:YERIELIS
Middle Name:
Last Name:RUBILAR-RIVERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 NEWHOUSE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01118-2566
Mailing Address - Country:US
Mailing Address - Phone:413-654-8062
Mailing Address - Fax:
Practice Address - Street 1:25 UNION ST STE 3
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1141
Practice Address - Country:US
Practice Address - Phone:508-317-2323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional