Healthcare Provider Details

I. General information

NPI: 1861540940
Provider Name (Legal Business Name): HOWARD JEFFREY RIESEL LCSW, LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 TOWNE CENTRE BLVD UNIT 506
ANNAPOLIS MD
21401-3733
US

IV. Provider business mailing address

1910 TOWNE CENTRE BLVD UNIT 506
ANNAPOLIS MD
21401-3733
US

V. Phone/Fax

Practice location:
  • Phone: 516-443-1738
  • Fax: 443-782-3502
Mailing address:
  • Phone: 516-443-1738
  • Fax: 443-782-3502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number30852
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberPR023372-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: