Healthcare Provider Details

I. General information

NPI: 1881435501
Provider Name (Legal Business Name): RILEY C ROLING PLMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17611 E US HIGHWAY 24
INDEPENDENCE MO
64056-1853
US

IV. Provider business mailing address

PO BOX 844715
KANSAS CITY MO
64184-4715
US

V. Phone/Fax

Practice location:
  • Phone: 816-836-6350
  • Fax:
Mailing address:
  • Phone: 417-761-5214
  • Fax: 417-761-5065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number2025004312
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: