Provider Demographics
NPI:1740588334
Name:RIEWERTS, HALI ELISE (LCSW)
Entity Type:Individual
Prefix:
First Name:HALI
Middle Name:ELISE
Last Name:RIEWERTS
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 1:1414 REEVES DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-9645
Mailing Address - Country:US
Mailing Address - Phone:970-692-9368
Mailing Address - Fax:
Practice Address - Street 1:1027 W HORSETOOTH RD UNIT 200
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80526-5982
Practice Address - Country:US
Practice Address - Phone:970-692-9368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW-15771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical