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General NPI Number Information
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NPI Number | 1619407319
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Entity Type | Individual
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Provider Name | JAMES ROGER RILEY LPC, LMFT
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Gender | Male
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 1522 W FRANK AVE
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City | LUFKIN
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State | TX
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Zip | 75904-3334
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Country | US
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Telephone | 936-346-9744
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Fax | 936-639-9888
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Provider Business Mailing Address
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Address Line | 505 N SAM HOUSTON PKWY E STE 308
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City | HOUSTON
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State | TX
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Zip | 77060-4086
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Country | US
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Telephone | 281-999-4859
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Fax | 281-447-1722
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 11407
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 11407
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License Number State | TX
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