Provider Demographics
NPI:1609370535
Name:RIFKIN, CAROLYN BYRNE
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:BYRNE
Last Name:RIFKIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-2229
Mailing Address - Country:US
Mailing Address - Phone:203-824-2385
Mailing Address - Fax:
Practice Address - Street 1:1901 ADAMS FARM PKWY
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-6338
Practice Address - Country:US
Practice Address - Phone:336-772-7266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11948101YP2500X
NC11948101YP2500X
NC22296101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)