RILEY HAYES GOODALL (MSW, LICSW) – Clinical Social Worker, NPI 1164123857

RILEY HAYES GOODALL (MSW, LICSW) is a healthcare provider. based in Victoria, Minnesota. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials MSW, LICSW. They hold a License No. 23749 (MN). The NPI Number for RILEY HAYES GOODALL (MSW, LICSW) is 1164123857

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
RILEY HAYES GOODALL (MSW, LICSW)
NPI
1164123857
Phone
(763) 614-6766
Address
1485 WINTERGREEN CT
Enumeration Date
10 March 2023
Last Update Date
10 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6513138080
Graduation Year
2014 (12 years ago)
PAC ID
2668846163
Group Practice PAC ID
6406752492
Professional Enrollment ID
I20230324000173
Address ID
MN553174588CH600XXSTXX302
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

2,341 CLINICAL SOCIAL WORKER in MN

Provider Addresses for RILEY HAYES GOODALL (MSW, LICSW)

  • 1485 WINTERGREEN CT

    VICTORIA, MN 553869586

    Phone: (763) 614-6766

    Type: Mailing

  • 600 MARKET ST STE 220

    CHANHASSEN, MN 553174588

    Phone: (651) 213-9280

    Fax: (651) 433-7122

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-03-24

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230324000173IClinical Social WorkerMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55386)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6406752492View full group profile
NameSpecialtyState
-GA
Clinical PsychologistMN
Mental Health CounselorMN
Clinical Social WorkerMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Mental Health CounselorMN
Mental Health CounselorMN
Clinical Social WorkerMN
Clinical PsychologistMN

Reviews

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Frequently asked questions

What is the 10-digit NPI for RILEY HAYES GOODALL (MSW, LICSW)?
RILEY HAYES GOODALL (MSW, LICSW) — NPI 1164123857 — is the standard way to identify this listing.
Is RILEY HAYES GOODALL (MSW, LICSW) listed as active for patients and plans?
The listing shows RILEY HAYES GOODALL (MSW, LICSW) as active in the NPI system.
What healthcare role does RILEY HAYES GOODALL (MSW, LICSW) hold?
Scheduling teams often label RILEY HAYES GOODALL (MSW, LICSW) under Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where is RILEY HAYES GOODALL (MSW, LICSW) based?
RILEY HAYES GOODALL (MSW, LICSW) is tied to Victoria, Minnesota in the data we show; additional addresses may exist on the full record.
Is the information about RILEY HAYES GOODALL (MSW, LICSW) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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