Provider Demographics
NPI:1821446238
Name:RIETVELD & ASSOCIATES COUNSELING, P.C.
Entity Type:Organization
Organization Name:RIETVELD & ASSOCIATES COUNSELING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RIETVELD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCPC
Authorized Official - Phone:815-265-6561
Mailing Address - Street 1:101 N VIRGINIA ST STE 110
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-3454
Mailing Address - Country:US
Mailing Address - Phone:815-265-6561
Mailing Address - Fax:
Practice Address - Street 1:101 N VIRGINIA ST STE 110
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-3454
Practice Address - Country:US
Practice Address - Phone:815-265-6561
Practice Address - Fax:224-330-1928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-25
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty