Provider Demographics
NPI:1225148695
Name:CRIPE, RICHARD V (PHYD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:V
Last Name:CRIPE
Suffix:
Gender:M
Credentials:PHYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2916 E HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-5936
Mailing Address - Country:US
Mailing Address - Phone:208-665-0010
Mailing Address - Fax:
Practice Address - Street 1:2916 E HARRISON AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-5936
Practice Address - Country:US
Practice Address - Phone:208-665-0010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPSY 355101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTN5277OtherBLUE CROSS
ID000010027086OtherBLUE SHIELD
S70030Medicare UPIN
ID000010027086OtherBLUE SHIELD