Provider Demographics
NPI:1518068618
Name:RIES, MARI E (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARI
Middle Name:E
Last Name:RIES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:MARI
Other - Middle Name:ELENA
Other - Last Name:APPELT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4203 WOODCOCK DR
Mailing Address - Street 2:SUITE 265
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1320
Mailing Address - Country:US
Mailing Address - Phone:210-737-2674
Mailing Address - Fax:210-734-2412
Practice Address - Street 1:4203 WOODCOCK DR
Practice Address - Street 2:SUITE 265
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1320
Practice Address - Country:US
Practice Address - Phone:210-737-2674
Practice Address - Fax:210-734-2412
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC14322101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX095865403Medicaid
TX528735OtherVO PROVIDER NUMBER
TX83801LOtherBCBS PROVIDER NUMBER
TX095865402Medicaid