Provider Demographics
NPI:1003949264
Name:PURDY, RICHARD R (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:R
Last Name:PURDY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 LONGFORD DR
Mailing Address - Street 2:
Mailing Address - City:CRESCENT SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-5362
Mailing Address - Country:US
Mailing Address - Phone:859-426-5686
Mailing Address - Fax:
Practice Address - Street 1:8859 BROOKSIDE CT
Practice Address - Street 2:SUITE 101
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-7113
Practice Address - Country:US
Practice Address - Phone:513-779-6225
Practice Address - Fax:513-779-6905
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3086103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist