Provider Demographics
NPI:1164636833
Name:HOPKINS, RICHARD R JR (LCSW)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:R
Last Name:HOPKINS
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 WASHBURN AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-7024
Mailing Address - Country:US
Mailing Address - Phone:704-492-4819
Mailing Address - Fax:
Practice Address - Street 1:3325 WASHBURN AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-7024
Practice Address - Country:US
Practice Address - Phone:704-492-4819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0056361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106706Medicaid