Provider Demographics
NPI:1639220122
Name:RIGGS, NORMAN TODD (MDIV, LICSW)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:TODD
Last Name:RIGGS
Suffix:
Gender:M
Credentials:MDIV, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 STINSON BLVD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-3488
Mailing Address - Country:US
Mailing Address - Phone:612-706-9630
Mailing Address - Fax:
Practice Address - Street 1:4001 STINSON BLVD
Practice Address - Street 2:SUITE 404
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55421-3488
Practice Address - Country:US
Practice Address - Phone:612-706-9630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN75691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical