Provider Demographics
NPI:1306913579
Name:RIGGS, CHARLES (CC)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:RIGGS
Suffix:
Gender:M
Credentials:CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 SOKOKIS TRAIL
Mailing Address - Street 2:
Mailing Address - City:BUXTON
Mailing Address - State:ME
Mailing Address - Zip Code:04093
Mailing Address - Country:US
Mailing Address - Phone:207-929-3833
Mailing Address - Fax:
Practice Address - Street 1:92 SOKOKIS TRL
Practice Address - Street 2:
Practice Address - City:BUXTON
Practice Address - State:ME
Practice Address - Zip Code:04093-3059
Practice Address - Country:US
Practice Address - Phone:207-929-3833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC3173101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional