Nicole Riley, MA, LLPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6451023916 Issued in MI

Practice address

678 Front Ave NW Ste 100
Grand Rapids, MI 49504-5323

Phone

(616) 916-3711

NPI assigned

Sep 25, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Nicole Mendez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1508683053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10875 DOUGLAS DR",
            "city": "ALLENDALE",
            "state": "MI",
            "postal_code": "494017406",
            "telephone_number": "773-951-5243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 FRONT AVE NW STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045323",
            "telephone_number": "616-916-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MA, LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6451023916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MENDEZ",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jason Andrew Riley, CRNA
• Jessica Ann Riley
• John B Riley, DO
• Kellie Riley, CNP
• Michelle Riley, BA
• Robert Riley, MD
• Rodney Phillip Riley II
• Steffano Riley, BEHAVIOR TECHNICIAN
• Jordan Rillera
• Carolyn Rimanelli, MA, LPC

• Counselor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.