Healthcare Provider Details

I. General information

NPI: 1841322237
Provider Name (Legal Business Name): RICHARD JOSEPH ESTELL PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4974 W ROLLING GLEN DR
PIPERSVILLE PA
18947-1072
US

IV. Provider business mailing address

4974 W ROLLING GLEN DR
PIPERSVILLE PA
18947-1072
US

V. Phone/Fax

Practice location:
  • Phone: 215-766-9928
  • Fax: 609-633-1526
Mailing address:
  • Phone: 215-766-9928
  • Fax: 609-633-1526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSI01172
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: