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General NPI Number Information
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NPI Number | 1255061081
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Entity Type | Individual
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Provider Name | JACQUELINE MARIE RIFE LICSW
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Gender | Female
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 9029 WHITE WILLOW WAY
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City | MORGANTOWN
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State | WV
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Zip | 26505-6224
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Country | US
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Telephone | 305-544-7085
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Fax |
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Provider Business Mailing Address
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Address Line | 714 VENTURE DR # 115
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City | MORGANTOWN
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State | WV
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Zip | 26508-7306
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Country | US
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Telephone | 304-544-7085
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | DP00946329
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License Number State | WV
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