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General NPI Number Information
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NPI Number | 1285130377
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Entity Type | Individual
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Provider Name | RICHARD J HOLDEN LADC, LCSW
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Gender | Male
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Dates
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Enumeration Date | 04/05/2018
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 33 PROSPECT ST
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City | TORRINGTON
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State | CT
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Zip | 06790-6329
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Country | US
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Telephone | 860-618-5858
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Fax |
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Provider Business Mailing Address
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Address Line | 73 CANTON RD
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City | WEST SIMSBURY
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State | CT
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Zip | 06092-2808
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Country | US
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Telephone | 860-651-6402
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 000149
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0005454
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License Number State | CT
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