Healthcare Provider Details

I. General information

NPI: 1942312400
Provider Name (Legal Business Name): JOSEPH JOHN RICHARD JR. E.D.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 HOSPITAL PLZ
CLARKSBURG WV
26301-9316
US

IV. Provider business mailing address

6 HOSPITAL PLZ
CLARKSBURG WV
26301-9316
US

V. Phone/Fax

Practice location:
  • Phone: 304-269-5220
  • Fax: 304-623-2180
Mailing address:
  • Phone: 304-269-5220
  • Fax: 304-623-2180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number500
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number22052
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: