=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245147867
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BROOKE RAMSEY RILEY M.E.D., NCC, LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/27/2026
-----------------------------------------------------
Last Update Date | 08/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 223 ROSWELL ST STE 201
-----------------------------------------------------
City | ALPHARETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30009-2019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 470-231-5355
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 223 ROSWELL ST STE 201
-----------------------------------------------------
City | ALPHARETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30009-2019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 470-231-5355
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | LPC017203
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------