Provider Demographics
NPI:1376144196
Name:RIEKE, KARINA (LMHC, CHT)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:RIEKE
Suffix:
Gender:F
Credentials:LMHC, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 MERSEREAU AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-1105
Mailing Address - Country:US
Mailing Address - Phone:917-558-0796
Mailing Address - Fax:
Practice Address - Street 1:29 MERSEREAU AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553-1105
Practice Address - Country:US
Practice Address - Phone:917-558-0796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010234101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty