Individual provider Active NPI

Christina Ella Emde Riley, L.C.S.W.

  • Clinical Social Worker
  • Driggs, ID
National Provider Identifier
1043377120
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-26777 Issued in ID
Practice address
158 N Orth First East Street
Driggs, ID 83422
Phone
(307) 730-7060
Fax
(208) 787-5683
NPI assigned
Jan 2, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-26777 ID Primary
Clinical Social Worker 1041C0700X LCSW-377 WY

Addresses

Primary practice location

158 N Orth First East Street
Driggs, ID 83422

Mailing address

163 E 1025 S
Victor, ID 83455-5503
Phone (307) 730-7060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070622000370 ID Practitioner - Clinical Social Worker 8628031697 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1420 N Hwy 33
Suite 207
Driggs, ID 83422-5316
Phone (307) 730-7060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-377WYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Laura McKee Psy D L L C Past Accepting new patients
Mental Health & Recovery Services of Jackson Hole PastSince Nov 7, 2025 Accepting new patients
Mental Health & Recovery Services of Jackson Hole PastSince Jun 1, 2014 Accepting new patients
Teton Headwaters, Inc Dba Aspen Wellness Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043377120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 E 1025 S",
            "city": "VICTOR",
            "state": "ID",
            "postal_code": "834555503",
            "telephone_number": "307-730-7060",
            "fax_number": "208-787-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 N ORTH FIRST EAST STREET",
            "city": "DRIGGS",
            "state": "ID",
            "postal_code": "83422",
            "telephone_number": "307-730-7060",
            "fax_number": "208-787-5683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "CHRISTINA",
        "middle_name": "ELLA EMDE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-26777",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-377",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Driggs, ID

Sources for this page

Verify at the official NPI Registry.