Provider Demographics
NPI:1780361451
Name:RILEY, SEAN C (PLPC)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:C
Last Name:RILEY
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54002 HIGHWAY 1062
Mailing Address - Street 2:
Mailing Address - City:LORANGER
Mailing Address - State:LA
Mailing Address - Zip Code:70446-3538
Mailing Address - Country:US
Mailing Address - Phone:985-606-2273
Mailing Address - Fax:
Practice Address - Street 1:54002 HIGHWAY 1062
Practice Address - Street 2:
Practice Address - City:LORANGER
Practice Address - State:LA
Practice Address - Zip Code:70446-3538
Practice Address - Country:US
Practice Address - Phone:985-606-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC9652101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor