1154544070 NPI number — E. ANNE RILEY, PH.D., LCSW-C

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154544070 NPI number — E. ANNE RILEY, PH.D., LCSW-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
E. ANNE RILEY, PH.D., LCSW-C
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154544070
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3144 GRACEFIELD RD
Provider Second Line Business Mailing Address:
APT T19
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20904-5895
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-273-2424
Provider Business Mailing Address Fax Number:
301-273-2426

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3144 GRACEFIELD RD
Provider Second Line Business Practice Location Address:
APT T19
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20904-5895
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-273-2424
Provider Business Practice Location Address Fax Number:
301-273-2426
Provider Enumeration Date:
04/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RILEY
Authorized Official First Name:
E. ANNE
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PROVIDER
Authorized Official Telephone Number:
301-273-2424

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  00761 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: Q1-0000139 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1006810 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 182331100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 252779000 . This is a "MAGELLAN" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 7183215 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1000037342 . This is a "DELAWARE MEDICAID" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 217899 . This is a "KAISER PERMANENTE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1006810 . This is a "CIGNA" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 182331101 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 217899 . This is a "KAISER PERMANENTE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 2148787 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 001069 . This is a "VALUEOPTIONS" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 7183215 . This is a "AETNA" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: H106-0001 . This is a "CAREFIRST BCBS NCA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 001069 . This is a "VALUEOPTIONS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2148787 . This is a "MAMSI" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 252779000 . This is a "MAGELLAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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