Provider Demographics
NPI:1992570048
Name:HARRIS, RILEY JAMES
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:JAMES
Last Name:HARRIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5025 THACHER RD
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-8304
Mailing Address - Country:US
Mailing Address - Phone:732-232-8500
Mailing Address - Fax:
Practice Address - Street 1:450 BEDFORD ST STE 2400
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-1544
Practice Address - Country:US
Practice Address - Phone:781-633-7779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALCSW21404191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical