Provider Demographics
NPI:1619697943
Name:REBECCA J RILEY PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:REBECCA J RILEY PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:J
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-235-6059
Mailing Address - Street 1:8031 W CENTER RD STE 310
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-3134
Mailing Address - Country:US
Mailing Address - Phone:402-235-6059
Mailing Address - Fax:
Practice Address - Street 1:8031 W CENTER RD STE 310
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3134
Practice Address - Country:US
Practice Address - Phone:402-235-6059
Practice Address - Fax:844-877-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty