Provider Demographics
NPI:1275259624
Name:RIFENBURG, ASHLEY (LCMHC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:RIFENBURG
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 N MAIN ST STE 214
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-3183
Mailing Address - Country:US
Mailing Address - Phone:704-825-9696
Mailing Address - Fax:866-880-8347
Practice Address - Street 1:908 LAYE ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-3523
Practice Address - Country:US
Practice Address - Phone:919-623-3973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-18
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA16925101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health