Provider Demographics
NPI:1720016785
Name:RICHARDS, DAVID FORREST (PHD, BCBA, LP)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:FORREST
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:PHD, BCBA, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 COTTIAN LN NW
Mailing Address - Street 2:
Mailing Address - City:VALDESE
Mailing Address - State:NC
Mailing Address - Zip Code:28690-2160
Mailing Address - Country:US
Mailing Address - Phone:828-874-1515
Mailing Address - Fax:828-874-1515
Practice Address - Street 1:111 COTTIAN LN NW
Practice Address - Street 2:
Practice Address - City:VALDESE
Practice Address - State:NC
Practice Address - Zip Code:28690-2160
Practice Address - Country:US
Practice Address - Phone:828-874-1515
Practice Address - Fax:828-874-1515
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3237103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral