Provider Demographics
NPI:1659137545
Name:JARRELL, RILEY MARIE (CSW)
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:MARIE
Last Name:JARRELL
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:RILEY
Other - Middle Name:MARIE
Other - Last Name:JARRELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RILEY JARRELL, CSW
Mailing Address - Street 1:3800 NICHOLASVILLE RD APT 12317
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-6349
Mailing Address - Country:US
Mailing Address - Phone:812-746-0294
Mailing Address - Fax:
Practice Address - Street 1:1001 GIBSON BAY DR FL 2
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-3544
Practice Address - Country:US
Practice Address - Phone:855-591-0092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2587491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical