Provider Demographics
NPI:1356440309
Name:RIGGEN, SUSAN M (LCMHC)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:RIGGEN
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:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05601-0647
Mailing Address - Country:US
Mailing Address - Phone:802-479-4083
Mailing Address - Fax:802-476-1476
Practice Address - Street 1:23 JONES BROTHERS WAY
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-2527
Practice Address - Country:US
Practice Address - Phone:802-479-4083
Practice Address - Fax:802-476-1476
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0000589101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00059172OtherBC/BS OF VT
VT360333OtherTRICARE
VT1009384Medicaid
VT2062406OtherCIGNA