Individual provider Active NPI

Michelle Riley, LCSW

  • Clinical Social Worker
  • Modesto, CA
National Provider Identifier
1083921977
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
70497 Issued in CA
Practice address
3340 Tully Rd Ste D4
Modesto, CA 95350
Phone
(209) 534-4927
NPI assigned
Sep 13, 2010
Last updated
May 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 70497 CA Primary

Addresses

Primary practice location

3340 Tully Rd Ste D4
Modesto, CA 95350

Mailing address

3340 Tully Rd Ste D4
Modesto, CA 95350-0852
Phone (209) 534-4927

Other practice location 1

500 N 9th St
Suite B
Modesto, CA 95350-5814
Phone (209) 341-1824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
70497CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hopenet Community Counseling a Licensed Clinical Social Worker Co Clinical CurrentSince Mar 20, 2022 Accepting new patients

Locations

3300 Tully Rd
Ste B6
Modesto, CA 95350
Phone (209) 485-3374

Organizations & group practices 1

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": "1284336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1083921977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 TULLY RD STE D4",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500852",
            "telephone_number": "209-534-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 TULLY RD STE D4",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95350",
            "telephone_number": "209-534-4927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 N 9th St",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953505814",
            "country_code": "US",
            "telephone_number": "209-341-1824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RILEY",
        "first_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-13",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "70497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.