Provider Demographics
NPI:1760618599
Name:RICH, PRISCILLA A (MA,NCC, LPC)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:A
Last Name:RICH
Suffix:
Gender:F
Credentials:MA,NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 EASTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-3662
Mailing Address - Country:US
Mailing Address - Phone:828-263-9169
Mailing Address - Fax:
Practice Address - Street 1:389 EASTVIEW DR
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-3662
Practice Address - Country:US
Practice Address - Phone:828-263-9169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2829101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health