Individual provider Active NPI

Brian Riley, L.I.C.S.W.

  • Clinical Social Worker
  • Fall River, MA
National Provider Identifier
1174561294
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1021872 Issued in MA
Practice address
1 Father Devalles Blvd
Fall River, MA 02723-1511
Phone
(508) 677-9072
Fax
(508) 677-4182
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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 1021872 MA Primary

Addresses

Primary practice location

1 Father Devalles Blvd
Fall River, MA 02723-1511

Mailing address

1 Father Devalles Blvd
Fall River, MA 02723-1511
Phone (508) 677-9072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20041129000161 MA Practitioner - Clinical Social Worker 4284699521 Practice locations: Fall River, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10 N Main St
Suite 2a
Fall River, MA 02720-2130
Phone (508) 677-9072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1021872MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1174561294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FATHER DEVALLES BLVD",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027231511",
            "telephone_number": "508-677-9072",
            "fax_number": "508-677-4182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FATHER DEVALLES BLVD",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027231511",
            "telephone_number": "508-677-9072",
            "fax_number": "508-677-4182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "L.I.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1021872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

Verify at the official NPI Registry.