Healthcare Provider Details

I. General information

NPI: 1164041836
Provider Name (Legal Business Name): RILEY COUNSELING & BEHAVIORAL HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2020
Last Update Date: 04/13/2020
Certification Date: 04/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 HDSN VLY PROF PLZ
NEWBURGH NY
12550-3150
US

IV. Provider business mailing address

2 BALMVILLE RD
NEWBURGH NY
12550-1910
US

V. Phone/Fax

Practice location:
  • Phone: 845-595-4775
  • Fax: 614-455-1343
Mailing address:
  • Phone: 845-527-0110
  • Fax: 614-455-1343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIE RILEY
Title or Position: OWNER
Credential: LCSW; PHD
Phone: 845-527-0110