Provider Demographics
NPI:1316022957
Name:RICHARD, DANIEL J (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:J
Last Name:RICHARD
Suffix:
Gender:M
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 WATER ST
Mailing Address - Street 2:SUITE B-236
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4060
Mailing Address - Country:US
Mailing Address - Phone:508-747-6302
Mailing Address - Fax:508-747-6304
Practice Address - Street 1:225 WATER ST
Practice Address - Street 2:SUITE B-236
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4060
Practice Address - Country:US
Practice Address - Phone:508-747-6302
Practice Address - Fax:508-747-6304
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2008-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4718101YM0800X
MA8756103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health