Provider Demographics
NPI:1518035153
Name:HORN, RICHARD WESLEY (DMIN, LMFT)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WESLEY
Last Name:HORN
Suffix:
Gender:M
Credentials:DMIN, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2961
Mailing Address - Country:US
Mailing Address - Phone:860-677-0845
Mailing Address - Fax:860-430-9752
Practice Address - Street 1:318 MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2961
Practice Address - Country:US
Practice Address - Phone:860-677-0845
Practice Address - Fax:860-430-9752
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000180106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist