Provider Demographics
NPI:1093975005
Name:DEMOTT, RICHARD T (MA,LPC,LCADC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:T
Last Name:DEMOTT
Suffix:
Gender:M
Credentials:MA,LPC,LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 S EUCLID AVE
Mailing Address - Street 2:2NF FLOOR
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-5116
Mailing Address - Country:US
Mailing Address - Phone:908-400-6914
Mailing Address - Fax:
Practice Address - Street 1:127 S EUCLID AVE
Practice Address - Street 2:2NF FLOOR
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-5116
Practice Address - Country:US
Practice Address - Phone:908-400-6914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00040400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional