Provider Demographics
NPI:1821004086
Name:BOUCHER, RICHARD O'NEIL (LMFT)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:O'NEIL
Last Name:BOUCHER
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 VIERA DRIVE
Mailing Address - Street 2:
Mailing Address - City:SWANNANOA
Mailing Address - State:NC
Mailing Address - Zip Code:28778-2309
Mailing Address - Country:US
Mailing Address - Phone:828-686-1870
Mailing Address - Fax:828-686-1870
Practice Address - Street 1:41 VIERA DRIVE
Practice Address - Street 2:
Practice Address - City:SWANNANOA
Practice Address - State:NC
Practice Address - Zip Code:28778-2309
Practice Address - Country:US
Practice Address - Phone:828-686-1870
Practice Address - Fax:828-686-1870
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1163106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1163OtherLMFT