| Doctor Name: | BEVERLY KAY RILEY |
| NPI Number: | 1003154774 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 2012033735 |
| Business Practice Address: | 140 S Holy Street Medford, OR - 975013113 |
| Business Phone Number: | 5417748201 |
| Business Fax Number: | 5417747979 |
| Mailing Address: | 6155 Oak St, Suite E KANSAS CITY |
| State: | MO |
| Postal Code: | 641132240 |
| Phone Number: | 8163330606 |
| Fax Number: | 8165235418 |
| NPI Enumeration Date: | 01/30/2013 |
| NPI Last Update Date: | 05/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 2012033735 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |