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NPI Code Detail

MEDICARE: MRS. ELIZABETH JEAN RILEY LCSW

MEDICARE:  MRS. ELIZABETH JEAN 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 WorkerC004012NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730173378
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH JEAN RILEY LCSW
Provider Business Mailing Address
First Line : 225 NANCY DR
Second Line :
City : SHELBY
State : NC
Zip : 28152-0903
Country : US
Telephone Number : 704-484-2880
Fax Number : 704-484-2880
Provider Business Practice Location Address
First Line : 215 S WASHINGTON ST
Second Line : SUITE 105
City : SHELBY
State : NC
Zip : 28150-4675
Country : US
Telephone Number : 704-484-2880
Fax Number : 704-484-2880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/09/2005
Last Update Date : 07/08/2007

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Directions to “ MRS. ELIZABETH JEAN RILEY LCSW” Practice Location

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