Individual provider Active NPI

Lesley Riley, PH.D.

  • Professional Counselor
  • Evans, GA
National Provider Identifier
1275845927
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
004852 Issued in GA
Practice address
703 Bellhaven CT
Evans, GA 30809-7409
Phone
(678) 476-4122
NPI assigned
Jul 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 004852 GA Primary

Addresses

Primary practice location

703 Bellhaven CT
Evans, GA 30809-7409

Mailing address

703 Bellhaven CT
Evans, GA 30809-7409
Phone (678) 476-4122

Other practice location 1

11111 Houze Rd
Ste. 225
Roswell, GA 30076-5663
Phone (770) 436-9700 ext. 24

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
004852GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Psychiatric Group Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588636800000",
    "number": "1275845927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 BELLHAVEN CT",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308097409",
            "telephone_number": "678-476-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 BELLHAVEN CT",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308097409",
            "telephone_number": "678-476-4122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11111 Houze Rd",
            "address_2": "Ste. 225",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300765663",
            "country_code": "US",
            "telephone_number": "770-436-9700 x24",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RILEY",
        "first_name": "LESLEY",
        "name_prefix": "Mrs.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-10",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "004852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; 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.