Provider Demographics
NPI:1689862831
Name:CANFIELD, RICHARD BROOKS (MC, CEAP, LPC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:BROOKS
Last Name:CANFIELD
Suffix:
Gender:M
Credentials:MC, CEAP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3116 N 41ST PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-6413
Mailing Address - Country:US
Mailing Address - Phone:602-956-4299
Mailing Address - Fax:
Practice Address - Street 1:4635 S LAKESHORE DR
Practice Address - Street 2:SUITE 112
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7127
Practice Address - Country:US
Practice Address - Phone:480-345-4477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-0074101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health