Provider Demographics
NPI:1679717052
Name:RILEY COUNSELING AND CONSULTING PLC
Entity Type:Organization
Organization Name:RILEY COUNSELING AND CONSULTING PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:EBONIE
Authorized Official - Middle Name:LENISE
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:757-285-4413
Mailing Address - Street 1:2537 HARRIS CREEK CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-6817
Mailing Address - Country:US
Mailing Address - Phone:757-285-4413
Mailing Address - Fax:757-401-6962
Practice Address - Street 1:5900 E VIRGINIA BEACH BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-2530
Practice Address - Country:US
Practice Address - Phone:757-938-5379
Practice Address - Fax:757-802-9237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10807Medicare PIN