Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Juventino Diez

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1053953430

Juventino Diez is an Addiction (Substance Use Disorder) Counselor in Bronx, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2019
Specialties on file
4
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Practice location Address checks out

165 Mermaid Ln
Bronx, NY 10473-2499
Phone: (929) 303-0024
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Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X (NY)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X
Mental Health Counselor Taxonomy 101YM0800X
Pastoral Counselor Taxonomy 101YP1600X

Record details

NPI number1053953430
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 17, 2019
Last updated in NPPESOctober 17, 2019
Mailing address165 Mermaid Ln, Bronx, NY 10473-2499

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