Healthcare Provider Details

I. General information

NPI: 1407388101
Provider Name (Legal Business Name): CHRISTINE RIES LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2017
Last Update Date: 01/01/2026
Certification Date: 01/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 GREENE ST UNIT 11
ADEL IA
50003-1646
US

IV. Provider business mailing address

2111 GREENE ST UNIT 11
ADEL IA
50003-1646
US

V. Phone/Fax

Practice location:
  • Phone: 641-745-9664
  • Fax:
Mailing address:
  • Phone: 641-745-9664
  • Fax: 641-484-9477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number16054
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number113622
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number113622
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113622
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: