Basic Information
| Provider Information | |||||||||
| NPI: | 1164041836 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RILEY COUNSELING & BEHAVIORAL HEALTH SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 BALMVILLE RD | ||||||||
| Address2: | |||||||||
| City: | NEWBURGH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125501910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455270110 | ||||||||
| FaxNumber: | 6144551343 | ||||||||
| Practice Location | |||||||||
| Address1: | 5 HDSN VLY PROF PLZ | ||||||||
| Address2: | |||||||||
| City: | NEWBURGH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125503150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455954775 | ||||||||
| FaxNumber: | 6144551343 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2020 | ||||||||
| LastUpdateDate: | 04/13/2020 | ||||||||
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| AuthorizedOfficialLastName: | RILEY | ||||||||
| AuthorizedOfficialFirstName: | JULIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8455270110 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | LCSW; PHD | ||||||||
| NPICertificationDate: | 04/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | N | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 261QM0855X | N | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | 261QM0850X | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No ID Information.