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Individual
MRS. ANITA L RILEY
Active
Individual
MRS. ANITA L RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
113071
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042611055
TAX ID
MA
01
—
1004745
NHP
MA
01
—
1303287
MBHP
MA
05
—
1303287
—
MA
05
—
1306421
—
MA
01
—
703136
TUFTS
MA
01
—
M18633
BCBC
MA
01
—
M18684
BCBS
—
01
—
NP01332
BMC
MA
Enumeration date
12/13/2006
Last updated
07/15/2009
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