Healthcare Provider Details

I. General information

NPI: 1043961790
Provider Name (Legal Business Name): RILEY NICOLE MCLAUGHLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2022
Last Update Date: 04/03/2025
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

793 OLD ROUTE 119 HIGHWAY NORTH
INDIANA PA
15701
US

IV. Provider business mailing address

793 OLD ROUTE 119 HIGHWAY NORTH
INDIANA PA
15701
US

V. Phone/Fax

Practice location:
  • Phone: 724-465-5576
  • Fax:
Mailing address:
  • Phone: 724-465-5576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: