Provider Demographics
NPI:1225199326
Name:RILEY, LISA PAGLIARO (LCSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:PAGLIARO
Last Name:RILEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6994 HWY 18
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOPE
Mailing Address - State:WI
Mailing Address - Zip Code:53816
Mailing Address - Country:US
Mailing Address - Phone:608-988-4359
Mailing Address - Fax:
Practice Address - Street 1:6058 S CHESTNUT ST STE 100
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818-8947
Practice Address - Country:US
Practice Address - Phone:608-342-4853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3018-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39683500Medicaid