Provider Demographics
NPI:1447745062
Name:LAWLESS, RICHARD M (THD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:LAWLESS
Suffix:
Gender:M
Credentials:THD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:860 MONTAUK HIGHWAY
Mailing Address - Street 2:BUILDING 1
Mailing Address - City:WATER MILL
Mailing Address - State:NY
Mailing Address - Zip Code:11976
Mailing Address - Country:US
Mailing Address - Phone:631-219-4365
Mailing Address - Fax:631-287-0965
Practice Address - Street 1:860 MONTAUK HIGHWAY
Practice Address - Street 2:BUILDING 1
Practice Address - City:WATER MILL
Practice Address - State:NY
Practice Address - Zip Code:11976
Practice Address - Country:US
Practice Address - Phone:631-219-4365
Practice Address - Fax:631-287-0965
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral