Provider Demographics
NPI:1336478148
Name:RIEHM, LAURIE LYNN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:LYNN
Last Name:RIEHM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 W. MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-1015
Mailing Address - Country:US
Mailing Address - Phone:630-587-5631
Mailing Address - Fax:630-587-5631
Practice Address - Street 1:3140 W. MAIN STREET
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-1015
Practice Address - Country:US
Practice Address - Phone:630-587-5631
Practice Address - Fax:630-587-5631
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490055741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical