Mary B Riedel

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4671-125 Issued in WI

Legal business name

MARY B RIEDEL

Practice address

115 5TH Ave S
Suite 301
La Crosse, WI 54601-9200

Phone

(608) 799-1208

NPI assigned

Apr 14, 2014

Last updated

Apr 14, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary B Riedel, LPCNPI 1063755684

Title

Licensed Professional Counselor

Phone

(608) 799-1208

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary B. Riedel, MS

  • Professional Counselor
  • La Crosse, WI
  • NPI 1063755684
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1215356779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 GRANT ST",
            "city": "HOLMEN",
            "state": "WI",
            "postal_code": "546368614",
            "telephone_number": "608-799-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 5TH AVE S",
            "address_2": "SUITE 301",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546019200",
            "telephone_number": "608-799-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY B RIEDEL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-14",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "RIEDEL",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "LICENSED PROFESSIONAL COUNSELOR",
        "authorized_official_telephone_number": "608-799-1208",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4671-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100029060",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Lynn Martin
• Devyn Martinez, DC
• Rita A Martino, MS, LMFT
• Teague A Martis, M.D
• Kaylee Marx
• Sally Anne Mashak, B.S.W.
• Erin L Maslowski, MD
• Gina M Mason, CRNA
• Lisa Louise Massman, BSW
• Melissa Marie Massman, LPC-IT

• Professional Counselor in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.