Healthcare Provider Details

I. General information

NPI: 1992627582
Provider Name (Legal Business Name): DAVID CARTER RICHARD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 COMMUNITY WAY APT 612
STAUNTON VA
24401-4994
US

IV. Provider business mailing address

107 COMMUNITY WAY APT 612
STAUNTON VA
24401-4994
US

V. Phone/Fax

Practice location:
  • Phone: 407-576-9040
  • Fax:
Mailing address:
  • Phone: 407-576-9040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number0810008961
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: