Provider Demographics
NPI:1568832731
Name:RIGG, CHRISTINE (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:RIGG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 JOHNSON AVE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-2686
Mailing Address - Country:US
Mailing Address - Phone:631-687-0832
Mailing Address - Fax:
Practice Address - Street 1:606 JOHNSON AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-2686
Practice Address - Country:US
Practice Address - Phone:631-687-0832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY095763104100000X
NY0911171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker