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NPI Code Detail

MEDICARE: SARA RIETSCH MS, LPC, CAADC

MEDICARE: SARA RIETSCH MS, LPC, CAADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorMI
2101Y00000XCounselor6401015424MI

General Provider Information

NPI Number : 1265828917
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA RIETSCH MS, LPC, CAADC
Provider Business Mailing Address
First Line : 5458 GREEN BANK DR
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-9595
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5458 GREEN BANK DR
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-9595
Country : US
Telephone Number : 248-970-1362
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2015
Last Update Date : 08/08/2022

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