Provider Demographics
NPI:1710048699
Name:FLAHERTY, RICHARD P (LICSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:P
Last Name:FLAHERTY
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 FERRY RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01952-2605
Mailing Address - Country:US
Mailing Address - Phone:978-465-9139
Mailing Address - Fax:978-462-4941
Practice Address - Street 1:30 FERRY RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MA
Practice Address - Zip Code:01952-2605
Practice Address - Country:US
Practice Address - Phone:978-465-9139
Practice Address - Fax:978-462-4941
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1017061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA714827OtherTUFTS
MAP21251Medicare ID - Type Unspecified