Provider Demographics
NPI:1417075706
Name:MCNUTT, RICHARD C (LPC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:C
Last Name:MCNUTT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 BRADEN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1608
Mailing Address - Country:US
Mailing Address - Phone:724-847-3392
Mailing Address - Fax:
Practice Address - Street 1:470 BRADEN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-1608
Practice Address - Country:US
Practice Address - Phone:724-847-3392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA000597101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional