Individual provider Active NPI

Riley Wolles, LCSW, QMHP

  • Clinical Social Worker
  • Sioux Falls, SD
National Provider Identifier
1134849029
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6238 Issued in SD
Practice address
2020 S Norton Ave
Sioux Falls, SD 57105-2835
Phone
(605) 322-3601
NPI assigned
Aug 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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 6238 SD Primary

Addresses

Primary practice location

2020 S Norton Ave
Sioux Falls, SD 57105-2835

Mailing address

2020 S Norton Ave
Sioux Falls, SD 57105-2835
Phone (605) 322-3601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20221025002721 SD Practitioner - Clinical Social Worker 1254707748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6238SDMDClinical Social Worker
6700SDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan Current Accepting new patients
Avera McKennan PastSince Sep 4, 2022 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1134849029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 S NORTON AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052835",
            "telephone_number": "605-322-3601",
            "fax_number": "605-322-5479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 S NORTON AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052835",
            "telephone_number": "605-322-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLES",
        "first_name": "RILEY",
        "credential": "LCSW, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "6238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.