Healthcare Provider Details

I. General information

NPI: 1033408091
Provider Name (Legal Business Name): SUSANNE R RIEMER MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2011
Last Update Date: 03/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 FEDERAL ST MAPS COUNSELING SERVICES
KEENE NH
03431-3632
US

IV. Provider business mailing address

117 POOR FARM RD
NEW IPSWICH NH
03071-3835
US

V. Phone/Fax

Practice location:
  • Phone: 603-355-2244
  • Fax: 603-355-2299
Mailing address:
  • Phone: 603-291-0006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1567
License Number StateNH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier002438501
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerPTAN
# 2
Identifier3071855
Identifier TypeMEDICAID
Identifier StateNH
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: