Provider Demographics
NPI:1184613200
Name:RILEY, ELIZABETH ANNE (LCSW)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANNE
Last Name:RILEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:DR
Other - First Name:E. ANNE
Other - Middle Name:
Other - Last Name:RILEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3144 GRACEFIELD RD APT T19
Mailing Address - Street 2:RIDERWOOD VILLAGE, GARDEN VIEW
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-5895
Mailing Address - Country:US
Mailing Address - Phone:301-273-2424
Mailing Address - Fax:301-273-2426
Practice Address - Street 1:3144 GRACEFIELD RD APT T19
Practice Address - Street 2:RIDERWOOD VILLAGE, GARDEN VIEW
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-5895
Practice Address - Country:US
Practice Address - Phone:301-273-2424
Practice Address - Fax:301-273-2426
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD007611041C0700X
DEQ1-00001391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
348820-02OtherCAREFIRST BCBS MD
233332171OtherUNITED BEHAVIORAL HEALTH
MDQ268EAOtherCAREFIRST BCBS
MD182331100Medicaid
2148787OtherMAMSI/UHC
H106-0001OtherCAREFIRST BCBS NCA
480695000OtherMAGELLAN
7183215OtherAETNA
001069OtherVALUEOPTIONS
252779000OtherMAGELLAN
DE348820-01OtherCAREFIRST BCBS DE
1006810OtherCIGNA
217899OtherKAISER PERMANENTE
252779000OtherMAGELLAN
MD646334Medicare ID - Type UnspecifiedMEDICARE-MARYLAND OFFICE