Provider Demographics
NPI:1528576386
Name:RIFFEL, BRIDGET (LCPC)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:RIFFEL
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 BANGOR MALL BLVD # 1009
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3632
Mailing Address - Country:US
Mailing Address - Phone:207-573-2247
Mailing Address - Fax:
Practice Address - Street 1:49 FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3005
Practice Address - Country:US
Practice Address - Phone:207-299-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-15
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC5464101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional