Provider Demographics
NPI:1760633085
Name:TOTTEN, RICHARD ALFRED JR (LAC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALFRED
Last Name:TOTTEN
Suffix:JR
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 299
Mailing Address - Street 2:
Mailing Address - City:HOXIE
Mailing Address - State:AR
Mailing Address - Zip Code:72433-0299
Mailing Address - Country:US
Mailing Address - Phone:870-886-1333
Mailing Address - Fax:870-886-1334
Practice Address - Street 1:503 SE LINDSEY ST
Practice Address - Street 2:
Practice Address - City:HOXIE
Practice Address - State:AR
Practice Address - Zip Code:72433-2224
Practice Address - Country:US
Practice Address - Phone:870-869-1500
Practice Address - Fax:870-869-1505
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA1110107101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health