1033408091 NPI number — SUSANNE R RIEMER MSW, LICSW

Table of content: SUSANNE R RIEMER MSW, LICSW (NPI 1033408091)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033408091 NPI number — SUSANNE R RIEMER MSW, LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIEMER
Provider First Name:
SUSANNE
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSW, LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033408091
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
117 POOR FARM RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW IPSWICH
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03071-3835
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-291-0006
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 FEDERAL ST
Provider Second Line Business Practice Location Address:
MAPS COUNSELING SERVICES
Provider Business Practice Location Address City Name:
KEENE
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03431-3632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-355-2244
Provider Business Practice Location Address Fax Number:
603-355-2299
Provider Enumeration Date:
03/30/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  1567 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 002438501 . This is a "PTAN" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 3071855 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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