Provider Demographics
NPI:1053425751
Name:RIESER, JAMIE LEE (MS)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LEE
Last Name:RIESER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:JAMIE
Other - Middle Name:LEE
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 963
Mailing Address - Street 2:
Mailing Address - City:NEW ULM
Mailing Address - State:MN
Mailing Address - Zip Code:56073-0963
Mailing Address - Country:US
Mailing Address - Phone:507-354-0248
Mailing Address - Fax:507-354-0251
Practice Address - Street 1:9 1/2 N MINNESOTA ST
Practice Address - Street 2:
Practice Address - City:NEW ULM
Practice Address - State:MN
Practice Address - Zip Code:56073-1727
Practice Address - Country:US
Practice Address - Phone:507-354-0248
Practice Address - Fax:507-354-0251
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00333101YP2500X
MN1673106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN375KORIOtherBLUE CROSS BLUE SHIELD
MN136390OtherUCARE
MN1045142OtherPREFERRED ONE
MNHP54403OtherHEALTH PARTNERS