Healthcare Provider Details

I. General information

NPI: 1033044862
Provider Name (Legal Business Name): SEPTIMA HUTCHINSON RILEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 ALCOVY ST. STE 5 #77
MONROE GA
30655
US

IV. Provider business mailing address

333 ALCOVY ST. STE 5 #77
MONROE GA
30655
US

V. Phone/Fax

Practice location:
  • Phone: 943-266-2405
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW009891
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: