Provider Demographics
NPI:1417989542
Name:RILEY, ELAINA C (LISW)
Entity Type:Individual
Prefix:
First Name:ELAINA
Middle Name:C
Last Name:RILEY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2929 WESTOWN PARKWAY STE 110
Mailing Address - Street 2:DES MOINES PASTORAL COUNSELING CENTER
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266
Mailing Address - Country:US
Mailing Address - Phone:515-274-4006
Mailing Address - Fax:515-255-5697
Practice Address - Street 1:2929 WESTOWN PARKWAY STE 110
Practice Address - Street 2:DES MOINES PASTORAL COUNSELING CENTER
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266
Practice Address - Country:US
Practice Address - Phone:515-274-4006
Practice Address - Fax:515-255-5697
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA014431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical