Healthcare Provider Details

I. General information

NPI: 1265341689
Provider Name (Legal Business Name): JAMEL RILEY LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N HOWARD ST
BALTIMORE MD
21218-5909
US

IV. Provider business mailing address

20 CHANNING ST NW UNIT 2
WASHINGTON DC
20001-1030
US

V. Phone/Fax

Practice location:
  • Phone: 443-438-6742
  • Fax:
Mailing address:
  • Phone: 313-613-9064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number35340
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: