Tracy M Riley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW9355 Issued in FL

Practice address

10151 Deerwood Park Blvd Ste 200-250
Jacksonville, FL 32256

Phone

(904) 704-2527

NPI assigned

Oct 17, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, NY2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tracyriley@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tracy Riley Counseling LLC

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1902239270
  Medicare reassignment NPD Authorized official
• Che Behavioral Health Services of Florida, P.a.

  • Community/Behavioral Health Agency
  • Fort Lauderdale, FL
  • NPI 1932721206

  Clinical

  Medicare reassignment NPD
• Che Senior Psychological Services, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1023078219
  Medicare reassignment NPD
• Knapp Street Psychiatry, PC

  • Clinical Psychologist
  • Brooklyn, NY
  • NPI 1043248776
  Medicare reassignment NPD
• New Hope, LLC

  • Clinical Social Worker
  • Macclenny, FL
  • NPI 1629377080
  NPD (past) Authorized official
• Tracy Riley Counseling LLC

  • Community/Behavioral Health Agency
  • Jacksonville, FL
  • NPI 1306234950
  NPD (past) Authorized official
• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1192579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1679762553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10151 DEERWOOD PARK BLVD STE 200-250",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560589",
            "telephone_number": "904-704-2527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 DEERWOOD PARK BLVD STE 200-250",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-704-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "TRACY",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-17",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW 4412",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008697300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosalyn A Riley
• Safari Riley
• Sharhonda Riley, RBT
• Shiobhan Riley
• Taneisha Riley, MASTER LEVEL
• Matthew C Rill, MD
• Pam Rillstone, PHD, ARNP, CNS
• Abdallah O. Rimawi, MD
• Kennedy James Ringelberg, MD
• Robin Ringer

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.