MEDICARE: MS. HELEN IRENE RILEY LPC

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	101Y00000X	Counselor	C.2305603	OH

General Provider Information

NPI Number	:	1174305239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HELEN IRENE RILEY LPC

Provider Business Mailing Address
First Line	:	125 GRIESHOP ST APT 205
Second Line	:
City	:	MOUNT ORAB
State	:	OH
Zip	:	45154-0260
Country	:	US
Telephone Number	:	937-789-9694
Fax Number	:

Provider Business Practice Location Address
First Line	:	4050 EXECUTIVE PARK DR STE 100
Second Line	:
City	:	SHARONVILLE
State	:	OH
Zip	:	45241-2020
Country	:	US
Telephone Number	:	513-427-6844
Fax Number	:

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

Provider Enumeration Date	:	10/13/2023
Last Update Date	:	11/21/2023

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