MEDICARE: JULIE A RILEY LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW19978	FL
2	1041C0700X	Clinical Social Worker	73084307	NY

General Provider Information

NPI Number	:	1003153669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE A RILEY LCSW

Provider Business Mailing Address
First Line	:	1123 SE 14TH ST
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-3718
Country	:	US
Telephone Number	:	845-527-0110
Fax Number	:

Provider Business Practice Location Address
First Line	:	1322 SE 46TH LN STE 201
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-8642
Country	:	US
Telephone Number	:	845-527-0110
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2013
Last Update Date	:	01/08/2026

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Directions to “ JULIE A RILEY LCSW” Practice Location

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