Provider Demographics
NPI:1033462338
Name:RIGGS, SIMONE (LMSW, MBA)
Entity Type:Individual
Prefix:MRS
First Name:SIMONE
Middle Name:
Last Name:RIGGS
Suffix:
Gender:F
Credentials:LMSW, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 TREASURE ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:MATTAWAN
Mailing Address - State:MI
Mailing Address - Zip Code:49071-9470
Mailing Address - Country:US
Mailing Address - Phone:269-815-6377
Mailing Address - Fax:
Practice Address - Street 1:3503 GREENLEAF BLVD STE 102
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-2580
Practice Address - Country:US
Practice Address - Phone:269-815-6377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801073097104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty