Provider Demographics
NPI:1790324671
Name:THRASH, RICHARD JR (QP)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:THRASH
Suffix:JR
Gender:M
Credentials:QP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PLOTT HOUND DR
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-7386
Mailing Address - Country:US
Mailing Address - Phone:919-880-3263
Mailing Address - Fax:
Practice Address - Street 1:2321 CRABTREE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27604-2263
Practice Address - Country:US
Practice Address - Phone:919-848-9108
Practice Address - Fax:919-848-9109
Is Sole Proprietor?:No
Enumeration Date:2019-12-24
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health