Healthcare Provider Details

I. General information

NPI: 1760404123
Provider Name (Legal Business Name): APRIL ELAINE RILEY MSW, LCSW, LISW-CP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 NW 13TH ST SUITE 120
GAINESVILLE FL
32609-5414
US

IV. Provider business mailing address

3919 NW 19TH TER
GAINESVILLE FL
32605-1813
US

V. Phone/Fax

Practice location:
  • Phone: 352-376-1611
  • Fax: 352-376-9482
Mailing address:
  • Phone: 352-375-5199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW7074
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLISW -CP 5540
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: