Provider Demographics
NPI:1356578009
Name:RIAT, DONNA T (LCSW)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:T
Last Name:RIAT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:T
Other - Last Name:RIAT-MAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1619 SUMMER RUN DR UNIT 23
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-6440
Mailing Address - Country:US
Mailing Address - Phone:314-313-8351
Mailing Address - Fax:
Practice Address - Street 1:1619 SUMMER RUN DR UNIT 23
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-6440
Practice Address - Country:US
Practice Address - Phone:314-313-8351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-200051041C0700X
MO20030155751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO499344109Medicaid