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General NPI Number Information
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NPI Number | 1699579342
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Entity Type | Individual
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Provider Name | HEATHER D RILEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 120 N MAIN ST
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City | EVANSVILLE
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State | IN
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Zip | 47711-5449
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Country | US
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Telephone | 812-422-6812
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Fax | 812-228-1113
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Provider Business Mailing Address
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Address Line | PO BOX 3276
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City | EVANSVILLE
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State | IN
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Zip | 47731-3276
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Country | US
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Telephone | 812-473-0181
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Fax | 812-492-6498
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 33010567A
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License Number State | IN
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