Healthcare Provider Details

I. General information

NPI: 1659141018
Provider Name (Legal Business Name): HAILEY MARIE RIEGLER MSW, LSW, CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 01/08/2024
Certification Date: 01/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 BUTTERMILK PIKE
CRESCENT SPRINGS KY
41017-1696
US

IV. Provider business mailing address

580 VALLEY RIDGE CIR UNIT D
COLD SPRING KY
41076-9321
US

V. Phone/Fax

Practice location:
  • Phone: 859-869-2023
  • Fax:
Mailing address:
  • Phone: 859-912-4957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number254845
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: