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NPI Code Detail

MEDICARE: JEAN L RILEY LPCC

MEDICARE: JEAN L RILEY LPCC
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 CounselorE-0002438OH

General Provider Information

NPI Number : 1609981596
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEAN L RILEY LPCC
Provider Business Mailing Address
First Line : 2243 YERRICK CIR
Second Line :
City : AKRON
State : OH
Zip : 44312-2333
Country : US
Telephone Number : 330-733-0028
Fax Number :
Provider Business Practice Location Address
First Line : 919 2ND ST NE
Second Line :
City : CANTON
State : OH
Zip : 44704-1132
Country : US
Telephone Number : 330-454-7917
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 07/08/2007

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Directions to “ JEAN L RILEY LPCC” Practice Location

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