Active NPI
Kelly Riley, LSW
- Social Worker
- Toledo, OH
National Provider Identifier
1780178046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.0600505
- Practice address
- 1219 Jefferson Ave
Toledo, OH 43604-5836 - Phone
- (567) 289-2273
- NPI assigned
- Jun 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.0600505 | OH | Primary |
Addresses
Primary practice location
1219 Jefferson Ave
Toledo, OH 43604-5836
Mailing address
1219 Jefferson Ave
Toledo, OH 43604-5836
Phone (567) 289-2273
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.0600505 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Youth Advocate Program, Inc | Past | Accepting new patients | |
| National Youth Advocate Program, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
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- NPI 1679721906
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Rockford, IL
- NPI 1841943495
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529452800000",
"number": "1780178046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1219 JEFFERSON AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436045836",
"telephone_number": "567-289-2273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1219 JEFFERSON AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436045836",
"telephone_number": "567-289-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "KELLY",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-20",
"last_updated": "2018-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.0600505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.