1316022957 NPI number — DR. DANIEL J. RICHARD PHD, LMHC

Table of content: DR. DANIEL J. RICHARD PHD, LMHC (NPI 1316022957)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316022957 NPI number — DR. DANIEL J. RICHARD PHD, LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RICHARD
Provider First Name:
DANIEL
Provider Middle Name:
J.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD, LMHC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316022957
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
225 WATER ST
Provider Second Line Business Mailing Address:
SUITE B-236
Provider Business Mailing Address City Name:
PLYMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02360-4060
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-747-6302
Provider Business Mailing Address Fax Number:
508-747-6304

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
225 WATER ST
Provider Second Line Business Practice Location Address:
SUITE B-236
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02360-4060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-747-6302
Provider Business Practice Location Address Fax Number:
508-747-6304
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  4718 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: 8756 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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