Provider Demographics
NPI:1508669193
Name:RIEKE, SARAH JOY (MSED)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JOY
Last Name:RIEKE
Suffix:
Gender:
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 BADEN AVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-2312
Mailing Address - Country:US
Mailing Address - Phone:757-635-6584
Mailing Address - Fax:
Practice Address - Street 1:5205 COLLEY AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-2043
Practice Address - Country:US
Practice Address - Phone:757-536-1233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-29
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704015543101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health