Provider Demographics
NPI:1083750566
Name:RIGGS-GUSTUS, CLEASTHER (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CLEASTHER
Middle Name:
Last Name:RIGGS-GUSTUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1908 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28562-6214
Mailing Address - Country:US
Mailing Address - Phone:252-670-1616
Mailing Address - Fax:252-636-2211
Practice Address - Street 1:3010 TRENT RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5735
Practice Address - Country:US
Practice Address - Phone:252-636-0001
Practice Address - Fax:252-636-2211
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0042301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003087Medicaid