Shelby Lake Riley, M.S., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MF000477 Issued in PA

Practice address

20 Mystic LN Ste a
Malvern, PA 19355-1942

Phone

(610) 883-3333

NPI assigned

Dec 16, 2008

Last updated

Dec 16, 2008By the provider in NPPES

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

Opted out of Medicare

Yes, effective Feb 27, 2024 through Feb 27, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1229385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1497991731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MYSTIC LN STE A",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551942",
            "telephone_number": "610-883-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MYSTIC LN STE A",
            "city": "MALVERN",
            "state": "PA",
            "postal_code": "193551942",
            "telephone_number": "610-883-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "SHELBY",
        "middle_name": "LAKE",
        "name_prefix": "Ms.",
        "credential": "M.S., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-16",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "MF000477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Malvern, PA
• Providers in Malvern, PA by specialty
• Marriage & Family Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.