Provider Demographics
NPI:1710687488
Name:RIES, JORDAN (LCSW)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:RIES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:
Other - Last Name:HEICHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:118 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:MCKNIGHT
Mailing Address - State:PA
Mailing Address - Zip Code:15237-3741
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8085 SALTSBURG RD STE 200
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15239-1975
Practice Address - Country:US
Practice Address - Phone:724-388-2852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW134190104100000X
PACW0235121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker