Provider Demographics
NPI:1538357827
Name:RILEY, CAROLYN MARIE (BS, MS)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MARIE
Last Name:RILEY
Suffix:
Gender:F
Credentials:BS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 656
Mailing Address - Street 2:
Mailing Address - City:GREEN HARBOR
Mailing Address - State:MA
Mailing Address - Zip Code:02041-0656
Mailing Address - Country:US
Mailing Address - Phone:617-930-3198
Mailing Address - Fax:
Practice Address - Street 1:88 FAUNCE CORNER RD STE 200
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747
Practice Address - Country:US
Practice Address - Phone:508-999-1102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor