Provider Demographics
NPI:1851732341
Name:RIES, DARCIE ELIZABETH (SSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DARCIE
Middle Name:ELIZABETH
Last Name:RIES
Suffix:
Gender:F
Credentials:SSW, LCSW
Other - Prefix:
Other - First Name:DARCIE
Other - Middle Name:ELIZABETH
Other - Last Name:WASENKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SSW, LMSW
Mailing Address - Street 1:12319 HIGHLAND RD
Mailing Address - Street 2:SUITE 501
Mailing Address - City:HARTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48353-2946
Mailing Address - Country:US
Mailing Address - Phone:810-991-1211
Mailing Address - Fax:810-991-1656
Practice Address - Street 1:12319 HIGHLAND RD
Practice Address - Street 2:SUITE 501
Practice Address - City:HARTLAND
Practice Address - State:MI
Practice Address - Zip Code:48353-2946
Practice Address - Country:US
Practice Address - Phone:810-991-1211
Practice Address - Fax:810-991-1656
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010849181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical