Provider Demographics
NPI:1457466302
Name:HUMMEL, RICHARD AUSTIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:AUSTIN
Last Name:HUMMEL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 BELMONT ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-1675
Mailing Address - Country:US
Mailing Address - Phone:508-791-3261
Mailing Address - Fax:508-795-1338
Practice Address - Street 1:275 BELMONT ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-1675
Practice Address - Country:US
Practice Address - Phone:508-791-3261
Practice Address - Fax:508-795-1338
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3697103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical