Patricia Marie Reilly, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

069334 Issued in NY

Practice address

172 Ravenhurst Ave
Rear Basement Office
Staten Island, NY 10310-2664

Phone

(347) 733-8172

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Jewish Board for Family and Children Services

  • Community/Behavioral Health Agency
  • Brooklyn, NY
  • NPI 1366685430
  NPD (past)
• Jewish Board of Family and Children'S Services, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Brooklyn, NY
  • NPI 1760173579

  Clinical

  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184633398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332B BARD AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103101662",
            "telephone_number": "347-733-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 RAVENHURST AVE",
            "address_2": "REAR BASEMENT OFFICE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103102664",
            "telephone_number": "347-733-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "PATRICIA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Patrick Reilly, MD
• Melissa T Reilly
• Michael Reilly, DDS
• Michele Reilly
• Michelle Marie Reilly, OTR/L
• Samantha Reilly, SLP
• Tiffany Berit Reilly, LMHC
• Michael Reimann, MSED
• Reimbursement and Billing Corporation
• Grace Trine Hanne Reinertsen, MS, CCC-SLP

• Clinical Social Worker in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.