Provider Demographics
NPI:1295079481
Name:RIGGS, PAMELA OLETTA (LPCC)
Entity type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:OLETTA
Last Name:RIGGS
Suffix:
Gender:F
Credentials:LPCC
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 7
Mailing Address - Street 2:
Mailing Address - City:CLARKSON
Mailing Address - State:KY
Mailing Address - Zip Code:42726-0007
Mailing Address - Country:US
Mailing Address - Phone:270-234-6139
Mailing Address - Fax:855-859-1695
Practice Address - Street 1:409 MILLERSTOWN ST
Practice Address - Street 2:
Practice Address - City:CLARKSON
Practice Address - State:KY
Practice Address - Zip Code:42726
Practice Address - Country:US
Practice Address - Phone:270-234-6139
Practice Address - Fax:855-859-1695
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-12
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1490101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100276780Medicaid