Provider Demographics
NPI:1568667616
Name:MOGOWSKI, MELINDA RIGGER (MS, LPC,LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:RIGGER
Last Name:MOGOWSKI
Suffix:
Gender:F
Credentials:MS, LPC,LCSW
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 3707
Mailing Address - Street 2:
Mailing Address - City:KILL DEVIL HILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27948-3707
Mailing Address - Country:US
Mailing Address - Phone:252-441-3536
Mailing Address - Fax:252-441-3536
Practice Address - Street 1:113 E SOTHEL ST
Practice Address - Street 2:SOTHEL LIGHT OFFICES, SUITE 6
Practice Address - City:KILL DEVIL HILLS
Practice Address - State:NC
Practice Address - Zip Code:27948-6961
Practice Address - Country:US
Practice Address - Phone:252-441-3536
Practice Address - Fax:252-441-3536
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2285101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional