Healthcare Provider Details

I. General information

NPI: 1639556202
Provider Name (Legal Business Name): RASHIDA MECCA RILEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2015
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 S. CLINTON STREET MAILSTOP CT 05-13
BALTIMORE MD
21224
US

IV. Provider business mailing address

1563 WITCHHAZEL CIR
GAMBRILLS MD
21054-1364
US

V. Phone/Fax

Practice location:
  • Phone: 410-953-1801
  • Fax:
Mailing address:
  • Phone: 240-940-3041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17205
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: