Provider Demographics
NPI:1023343746
Name:RIGGALL, ABIGAIL J (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ABIGAIL
Middle Name:J
Last Name:RIGGALL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:J
Other - Last Name:GOULD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 E DOCK ST
Mailing Address - Street 2:
Mailing Address - City:PORT BYRON
Mailing Address - State:NY
Mailing Address - Zip Code:13140-3358
Mailing Address - Country:US
Mailing Address - Phone:315-406-0174
Mailing Address - Fax:
Practice Address - Street 1:146 NORTH ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-1831
Practice Address - Country:US
Practice Address - Phone:315-253-0341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077724-1104100000X
NY0809431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker