Provider Demographics
NPI:1508616962
Name:RIGLING, JAMIE MARIE (LICSW/LADC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:MARIE
Last Name:RIGLING
Suffix:
Gender:F
Credentials:LICSW/LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17124 EASTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-7337
Mailing Address - Country:US
Mailing Address - Phone:507-383-7088
Mailing Address - Fax:
Practice Address - Street 1:17124 EASTWOOD AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55024-7337
Practice Address - Country:US
Practice Address - Phone:507-383-7088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN306212101YA0400X
MN184421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)