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General NPI Number Information
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NPI Number | 1891801304
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Entity Type | Individual
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Provider Name | PAUL V. RICHARD LCSW-C
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 01/08/2013
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Provider Practice Location Address
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Address Line | 41900 FENWICK ST SUITE 1
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City | LEONARDTOWN
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State | MD
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Zip | 20650-3813
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Country | US
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Telephone | 301-475-9660
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Fax | 301-475-8810
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Provider Business Mailing Address
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Address Line | PO BOX 643
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City | SOLOMONS
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State | MD
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Zip | 20688-0643
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Country | US
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Telephone | 410-326-4933
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 04310
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License Number State | MD
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