Active NPI
Blue Iridescent Riley, LICSW
- Clinical Social Worker
- St Louis Park, MN
National Provider Identifier
1902683410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 32669
- Practice address
- 7601 Wayzata Blvd
St Louis Park, MN 55426-1623 - Phone
- (612) 223-8898
- NPI assigned
- Sep 11, 2023
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 32669 | MN | Primary |
Addresses
Primary practice location
7601 Wayzata Blvd
St Louis Park, MN 55426-1623
Mailing address
7601 Wayzata Blvd
St Louis Park, MN 55426-1623
Phone (612) 223-8898
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32669 | MN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785715200000",
"number": "1902683410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7601 WAYZATA BLVD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554261623",
"telephone_number": "612-223-8898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7601 WAYZATA BLVD",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554261623",
"telephone_number": "612-223-8898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RILEY",
"first_name": "BLUE",
"middle_name": "IRIDESCENT",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-11",
"last_updated": "2026-08-03",
"certification_date": "2026-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "32669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.