Healthcare Provider Details

I. General information

NPI: 1073579652
Provider Name (Legal Business Name): WILLIAM JOSEPH RILEY MA, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 N PLUM ST SUITE 10
SPRINGFIELD OH
45504-2154
US

IV. Provider business mailing address

136 CARLISLE AVE SPRINGFIELD
SPRINGFIELD OH
45504-3503
US

V. Phone/Fax

Practice location:
  • Phone: 937-398-0014
  • Fax: 937-398-0022
Mailing address:
  • Phone: 937-398-0014
  • Fax: 937-398-0022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number965734
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE2401
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: