Provider Demographics
NPI:1891788493
Name:RIFFE, RUTH ANN (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
Last Name:RIFFE
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:RUTH
Other - Middle Name:ANN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LICSW
Mailing Address - Street 1:2505 WILLOW BEND RD
Mailing Address - Street 2:
Mailing Address - City:LINDSIDE
Mailing Address - State:WV
Mailing Address - Zip Code:24951-7271
Mailing Address - Country:US
Mailing Address - Phone:304-994-1973
Mailing Address - Fax:
Practice Address - Street 1:2505 WILLOW BEND RD
Practice Address - Street 2:
Practice Address - City:LINDSIDE
Practice Address - State:WV
Practice Address - Zip Code:24951
Practice Address - Country:US
Practice Address - Phone:304-994-1973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVCP009411811041C0700X
WVDP009411811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810000523Medicaid
WV3810000523Medicaid