Healthcare Provider Details

I. General information

NPI: 1134083363
Provider Name (Legal Business Name): BREE RILEY, LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 BELVOIR CREST DR
CHATTANOOGA TN
37412-2009
US

IV. Provider business mailing address

8735 DUNWOODY PL STE R
ATLANTA GA
30350-2995
US

V. Phone/Fax

Practice location:
  • Phone: 404-406-4646
  • Fax:
Mailing address:
  • Phone: 404-406-4646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BREEANNA MARY RILEY
Title or Position: AUTHORIZED SIGNATORY
Credential: LCSW
Phone: 404-406-4646