Provider Demographics
NPI:1811986409
Name:RIEBER, JESSE ALVIN (LMHC)
Entity type:Individual
Prefix:MR
First Name:JESSE
Middle Name:ALVIN
Last Name:RIEBER
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
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Mailing Address - Street 1:106 SPRING ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-5951
Mailing Address - Country:US
Mailing Address - Phone:508-999-3290
Mailing Address - Fax:508-999-3290
Practice Address - Street 1:106 SPRING ST
Practice Address - Street 2:SUITE 206
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-5951
Practice Address - Country:US
Practice Address - Phone:508-999-3290
Practice Address - Fax:508-999-3290
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MALMHC3758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000024172OtherBOSTON MED CENTER HLTHNET
MA284888OtherMAGELLAN AT&T
MA1033860OtherBEACON HEALTH STRATEGIES
MALM0804OtherBCBS
MALM0244OtherBCBS
MA0004469845OtherAETNA
MA1890719Medicaid
MAA024594OtherVALUE OPTIONS
MA18802000OtherMAGELLAN BEHAVIOURAL HLTH
MA229951OtherCOM PSYCH