Provider Demographics
NPI:1871959924
Name:RIETH, CHESTER MARTIN II (LCSW)
Entity type:Individual
Prefix:MR
First Name:CHESTER
Middle Name:MARTIN
Last Name:RIETH
Suffix:II
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2728 COLONIAL AVE SW
Mailing Address - Street 2:SUITE 5
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-3878
Mailing Address - Country:US
Mailing Address - Phone:540-344-8600
Mailing Address - Fax:540-685-4712
Practice Address - Street 1:2728 COLONIAL AVE SW
Practice Address - Street 2:SUITE 5
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24015-3878
Practice Address - Country:US
Practice Address - Phone:540-344-8600
Practice Address - Fax:540-685-4712
Is Sole Proprietor?:No
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040092801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical