Healthcare Provider Details

I. General information

NPI: 1346731353
Provider Name (Legal Business Name): ANDREW JOSEPH RIELINGER LISW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26900 CEDAR RD
BEACHWOOD OH
44122-1191
US

IV. Provider business mailing address

8172 DEEPWOOD BLVD UNIT 7
MENTOR OH
44060-7738
US

V. Phone/Fax

Practice location:
  • Phone: 216-839-3000
  • Fax:
Mailing address:
  • Phone: 440-283-5669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1700725
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI.2102966
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: