Healthcare Provider Details

I. General information

NPI: 1144149238
Provider Name (Legal Business Name): RILEY DWORACZYK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 BAKERTON RD
HARPERS FERRY WV
25425-4106
US

IV. Provider business mailing address

761 FRONT ROYAL PIKE APT 203
WINCHESTER VA
22602-7349
US

V. Phone/Fax

Practice location:
  • Phone: 571-364-0757
  • Fax:
Mailing address:
  • Phone: 713-502-2262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1135
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: