Provider Demographics
NPI:1730395484
Name:RILEY, DONALD PAUL (MSW)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:PAUL
Last Name:RILEY
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CHAPEL ST
Mailing Address - Street 2:604B
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-7458
Mailing Address - Country:US
Mailing Address - Phone:617-566-0916
Mailing Address - Fax:
Practice Address - Street 1:20 CHAPEL ST
Practice Address - Street 2:604B
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-7458
Practice Address - Country:US
Practice Address - Phone:617-566-0916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1039281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical