Provider Demographics
NPI:1477742492
Name:RIEVE, MICHAEL H (LADC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:H
Last Name:RIEVE
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 NASHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-2517
Mailing Address - Country:US
Mailing Address - Phone:203-241-0808
Mailing Address - Fax:203-792-2254
Practice Address - Street 1:72 NORTH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5648
Practice Address - Country:US
Practice Address - Phone:203-241-0808
Practice Address - Fax:203-792-2254
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-16
Last Update Date:2015-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000794101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)