Provider Demographics
NPI:1467661397
Name:KILLION, RICHARD C (LCSW-R, LICSW, CEAP)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:C
Last Name:KILLION
Suffix:
Gender:M
Credentials:LCSW-R, LICSW, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 ROBIN HILL RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3941
Mailing Address - Country:US
Mailing Address - Phone:914-539-1839
Mailing Address - Fax:
Practice Address - Street 1:10 ROBIN HILL RD
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3941
Practice Address - Country:US
Practice Address - Phone:914-539-1839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1113071041C0700X
NY0758771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical