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NPI Code Detail

MEDICARE: AMBER NICOLE RILEY LCSW

MEDICARE: AMBER NICOLE 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
11041C0700XClinical Social Worker6969TN

General Provider Information

NPI Number : 1275251514
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER NICOLE RILEY LCSW
Provider Business Mailing Address
First Line : 9433 WHITE OAK RD
Second Line :
City : LIBERTY
State : IL
Zip : 62347-2000
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6020 BROADWAY ST
Second Line :
City : QUINCY
State : IL
Zip : 62305-7919
Country : US
Telephone Number : 217-224-3366
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2022
Last Update Date : 08/22/2022

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Directions to “ AMBER NICOLE RILEY LCSW” Practice Location

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