Provider Demographics
NPI:1679906978
Name:RIGSBY, KENNETH (MSW, EDD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:
Last Name:RIGSBY
Suffix:
Gender:M
Credentials:MSW, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 112TH AVE N
Mailing Address - Street 2:#1322
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-3277
Mailing Address - Country:US
Mailing Address - Phone:727-674-5250
Mailing Address - Fax:
Practice Address - Street 1:401 CORBETT ST
Practice Address - Street 2:SUITE 340B
Practice Address - City:BELLEAIR
Practice Address - State:FL
Practice Address - Zip Code:33756-7309
Practice Address - Country:US
Practice Address - Phone:727-674-5250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-10
Last Update Date:2013-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW 73141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical