Provider Demographics
NPI:1285203109
Name:RILEY, JENNIFER W (MSW)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:W
Last Name:RILEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 N FRANKLIN ST STE 306
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-3536
Mailing Address - Country:US
Mailing Address - Phone:617-699-6171
Mailing Address - Fax:
Practice Address - Street 1:16 N FRANKLIN ST STE 306
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-3536
Practice Address - Country:US
Practice Address - Phone:617-699-6171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW130276101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health