Individual provider Active NPI

Christine L Riley, PSYD, LCSW

  • Social Worker
  • Ellwood City, PA
National Provider Identifier
1710080858
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
CW014971 Issued in PA
Practice address
226 Fifth St.
Ellwood City, PA 16117
Phone
(724) 681-2752
Fax
(724) 752-1113
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X CW014971 PA Primary

Addresses

Primary practice location

226 Fifth St.
Ellwood City, PA 16117

Mailing address

226 Fifth St.
Ellwood City, PA 16117
Phone (724) 681-2752

Other identifiers 1

IdentifierTypeStateIssuer
190764MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080201000018 PA Practitioner - Clinical Social Worker 3173605938 Practice locations: Ellwood City, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

226 5TH St
Ellwood City, PA 16117-2306
Phone (724) 681-2752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW014971PAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Familylinks, Inc PastSince Aug 26, 2008 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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1710080858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 FIFTH ST.",
            "city": "ELLWOOD CITY",
            "state": "PA",
            "postal_code": "16117",
            "telephone_number": "724-681-2752",
            "fax_number": "724-752-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 FIFTH ST.",
            "city": "ELLWOOD CITY",
            "state": "PA",
            "postal_code": "16117",
            "telephone_number": "724-681-2752",
            "fax_number": "724-752-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "CHRISTINE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PSYD, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "CW014971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190764",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellwood City, PA

Sources for this page

Verify at the official NPI Registry.