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General NPI Number Information
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NPI Number | 1962819847
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Entity Type | Individual
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Provider Name | CYNTHIA NORMAN RILEY LMT LPC
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Gender | Female
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Dates
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Enumeration Date | 07/12/2014
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Last Update Date | 05/05/2019
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Provider Practice Location Address
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Address Line | 2801 ISLAND AVE STE 14 FLOOR 1
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City | PHILADELPHIA
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State | PA
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Zip | 19153-2326
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Country | US
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Telephone | 484-844-9890
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Fax |
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Provider Business Mailing Address
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Address Line | 306 PINE ST
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City | WILLIAMSTOWN
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State | NJ
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Zip | 08094-1139
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Country | US
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Telephone | 443-941-4206
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Fax | 610-537-5043
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MSG008037
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License Number State | PA
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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 | PC007940
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License Number State | PA
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