Healthcare Provider Details

I. General information

NPI: 1366162935
Provider Name (Legal Business Name): PATRICK RILEY LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2022
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3763 N HIGH ST
COLUMBUS OH
43214-3547
US

IV. Provider business mailing address

1358 N GRANT AVE APT 204
COLUMBUS OH
43201-3924
US

V. Phone/Fax

Practice location:
  • Phone: 614-321-7883
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2607191
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: