Healthcare Provider Details

I. General information

NPI: 1316022957
Provider Name (Legal Business Name): DANIEL J. RICHARD PHD, LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 03/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 WATER ST SUITE B-236
PLYMOUTH MA
02360-4060
US

IV. Provider business mailing address

225 WATER ST SUITE B-236
PLYMOUTH MA
02360-4060
US

V. Phone/Fax

Practice location:
  • Phone: 508-747-6302
  • Fax: 508-747-6304
Mailing address:
  • Phone: 508-747-6302
  • Fax: 508-747-6304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4718
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8756
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: