MEDICARE: EMILY B RIEGEL M.ED. , L.M.H.C., PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH3390	FL

General Provider Information

NPI Number	:	1043467582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY B RIEGEL M.ED. , L.M.H.C., PA

Provider Business Mailing Address
First Line	:	4400 MARSH LANDING BLVD STE 104
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-1287
Country	:	US
Telephone Number	:	904-477-5452
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 MARSH LANDING BLVD STE 104
Second Line	:
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-1287
Country	:	US
Telephone Number	:	904-834-4433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	05/24/2026

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