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General NPI Number Information
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NPI Number | 1215210638
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Entity Type | Individual
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Provider Name | MICHAEL TROY RICH LCSW
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Gender | Male
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Dates
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Enumeration Date | 09/21/2011
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Last Update Date | 08/07/2024
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Provider Practice Location Address
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Address Line | 8903 SLAYTON ST
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City | PENDLETON
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State | IN
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Zip | 46064-0109
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Country | US
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Telephone | 765-717-3774
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Fax |
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Provider Business Mailing Address
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Address Line | 205 POWELL PL
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City | BRENTWOOD
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State | TN
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Zip | 37027-7522
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Country | US
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Telephone | 765-717-3774
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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