Judie Riley LCSW, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW017590 Issued in PA

Legal business name

JUDIE RILEY LCSW, LLC

Practice address

2601 Annand Dr Ste 20
Wilmington, DE 19808-3719

Phone

(302) 383-2078

NPI assigned

Apr 26, 2013

Last updated

Jan 3, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Judie Riley, LCSWNPI 1043559149

Title

Provider

Phone

(302) 383-2078

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA, DE2 enrollments

Enrollment records 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Judith Riley, LCSW

  • Clinical Social Worker
  • Wilmington, DE
  • NPI 1043559149

  PA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1366934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1932543410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 ANNAND DR STE 20",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198083719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 ANNAND DR STE 20",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198083719",
            "telephone_number": "302-383-2078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDIE RILEY LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-26",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "RILEY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JUDIE",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "302-383-2078",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSW LICENSE",
            "identifier": "CW017590",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSW LICENSE",
            "identifier": "Q1-0001229",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Clinical Social Worker in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.