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NPI Code Detail

MEDICARE: JERRY A. RIGGS SR. LMHC

MEDICARE: JERRY A. RIGGS SR. LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorIMH20787FL

General Provider Information

NPI Number : 1548917552
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERRY A. RIGGS SR. LMHC
Provider Business Mailing Address
First Line : 4000 HOLLYWOOD BLVD STE 715S
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-6755
Country : US
Telephone Number : 754-209-1880
Fax Number :
Provider Business Practice Location Address
First Line : 4000 HOLLYWOOD BLVD STE 715S
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-6755
Country : US
Telephone Number : 754-209-1880
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2022
Last Update Date : 03/09/2022

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