1457415267 NPI number — MRS. CATHERINE COOK RIGGS L.C.S.W.

Table of content: CLARISSA GUDINO PA-C (NPI 1710612999)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457415267 NPI number — MRS. CATHERINE COOK RIGGS L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIGGS
Provider First Name:
CATHERINE
Provider Middle Name:
COOK
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COOK
Provider Other First Name:
CATHERINE
Provider Other Middle Name:
LYNNE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.C.S.W.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1457415267
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 233
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKY GAP
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24366-0233
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-307-7231
Provider Business Mailing Address Fax Number:
276-385-7429

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
677 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAZEWELL
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24651-5401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-307-7231
Provider Business Practice Location Address Fax Number:
276-385-7429
Provider Enumeration Date:
12/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  0904003305 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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