Provider Demographics
NPI:1083316798
Name:RILEY, TANNER SCOTT (MS, NCC)
Entity Type:Individual
Prefix:MR
First Name:TANNER
Middle Name:SCOTT
Last Name:RILEY
Suffix:
Gender:M
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 CREST ST
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-1009
Mailing Address - Country:US
Mailing Address - Phone:724-552-8075
Mailing Address - Fax:
Practice Address - Street 1:1051 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-1553
Practice Address - Country:US
Practice Address - Phone:724-934-3905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health