Provider Demographics
NPI:1275519068
Name:RIFE, MICHAEL ERNEST (MED, LCAS, LPC)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ERNEST
Last Name:RIFE
Suffix:
Gender:M
Credentials:MED, LCAS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 KILSON DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8162
Mailing Address - Country:US
Mailing Address - Phone:704-660-8321
Mailing Address - Fax:704-660-8323
Practice Address - Street 1:107 KILSON DR
Practice Address - Street 2:SUITE 202
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8162
Practice Address - Country:US
Practice Address - Phone:704-660-8321
Practice Address - Fax:704-660-8323
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2215101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional