Provider Demographics
NPI:1275691529
Name:PERRONE, RICHARD A (LMFT, LADC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:A
Last Name:PERRONE
Suffix:
Gender:M
Credentials:LMFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 VINE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1433
Mailing Address - Country:US
Mailing Address - Phone:860-223-9291
Mailing Address - Fax:860-223-3111
Practice Address - Street 1:58 MAIN ST
Practice Address - Street 2:
Practice Address - City:TERRYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06786-5106
Practice Address - Country:US
Practice Address - Phone:860-589-6333
Practice Address - Fax:860-589-7934
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000587101YA0400X
CT000574106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist