Provider Demographics
NPI:1942699111
Name:RIEKERT, NAN (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:NAN
Middle Name:
Last Name:RIEKERT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1371 BEVERLY LN
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-9033
Mailing Address - Country:US
Mailing Address - Phone:859-536-5056
Mailing Address - Fax:
Practice Address - Street 1:1371 BEVERLY LN
Practice Address - Street 2:
Practice Address - City:NICHOLASVILLE
Practice Address - State:KY
Practice Address - Zip Code:40356-9033
Practice Address - Country:US
Practice Address - Phone:859-536-5056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical