Provider Demographics
NPI:1720023831
Name:RILEY THERAPY PA
Entity Type:Organization
Organization Name:RILEY THERAPY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:N
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW LISW CP
Authorized Official - Phone:864-241-4448
Mailing Address - Street 1:714 PETTIGRU STREET
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601
Mailing Address - Country:US
Mailing Address - Phone:864-241-4448
Mailing Address - Fax:864-292-6994
Practice Address - Street 1:714 PETTIGRU STREET
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601
Practice Address - Country:US
Practice Address - Phone:864-241-4448
Practice Address - Fax:864-292-6994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5414104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty