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NPI Code Detail

MEDICARE: JILL R RILEY PCC

MEDICARE: JILL R RILEY PCC
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
1101YM0800XMental Health CounselorC.1200250OH
2101YM0800XMental Health CounselorC.1200250-CROH
3101YP2500XProfessional CounselorE.1200250OH

General Provider Information

NPI Number : 1063851798
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL R RILEY PCC
Provider Business Mailing Address
First Line : 2845 BELL ST
Second Line :
City : ZANESVILLE
State : OH
Zip : 43701-1720
Country : US
Telephone Number : 740-454-9766
Fax Number : 740-588-6452
Provider Business Practice Location Address
First Line : 915 S RIVERSIDE DR NE
Second Line :
City : MCCONNELSVILLE
State : OH
Zip : 43756-9102
Country : US
Telephone Number : 740-454-9766
Fax Number : 740-588-6452
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2013
Last Update Date : 04/13/2016

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