Healthcare Provider Details

I. General information

NPI: 1346828092
Provider Name (Legal Business Name): RICHARD PAUL SALATIN LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2021
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 BIELBY RD
LAWRENCEBURG IN
47025-1055
US

IV. Provider business mailing address

4472 RACE LANE RD
OKEANA OH
45053-9594
US

V. Phone/Fax

Practice location:
  • Phone: 812-537-1302
  • Fax:
Mailing address:
  • Phone: 812-212-5331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39003848A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: