Provider Demographics
NPI:1366799546
Name:RIEKER, ALANA NICOLE (LSAA,LMSW)
Entity type:Individual
Prefix:MRS
First Name:ALANA
Middle Name:NICOLE
Last Name:RIEKER
Suffix:
Gender:F
Credentials:LSAA,LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 N BUTLER AVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-5621
Mailing Address - Country:US
Mailing Address - Phone:505-608-7398
Mailing Address - Fax:505-634-7044
Practice Address - Street 1:3300 N BUTLER AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-5621
Practice Address - Country:US
Practice Address - Phone:505-608-7398
Practice Address - Fax:505-634-7044
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0150681101YA0400X
NMM-081921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)