Provider Demographics
NPI:1942528856
Name:RIEDEL, BRIAN LLOYD (LPC LMFT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:LLOYD
Last Name:RIEDEL
Suffix:
Gender:M
Credentials:LPC LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 89306
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57109-9306
Mailing Address - Country:US
Mailing Address - Phone:605-332-6128
Mailing Address - Fax:605-335-3121
Practice Address - Street 1:6901 LYNCREST PL
Practice Address - Street 2:#106
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108
Practice Address - Country:US
Practice Address - Phone:605-332-6128
Practice Address - Fax:605-336-1097
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD585101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor