Provider Demographics
NPI:1053909028
Name:RIEGGER, KATELYN (LCSW-C)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:RIEGGER
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 RITCHIE HWY STE 205
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-4164
Mailing Address - Country:US
Mailing Address - Phone:443-261-5376
Mailing Address - Fax:
Practice Address - Street 1:815 RITCHIE HWY STE 205
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-4164
Practice Address - Country:US
Practice Address - Phone:443-261-5376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD232841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical