Provider Demographics
NPI:1831305770
Name:VANTREASE, RICHARD JAMES (LMFT)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAMES
Last Name:VANTREASE
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 1:800 CELEBRATION AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-4999
Mailing Address - Country:US
Mailing Address - Phone:407-566-1815
Mailing Address - Fax:321-939-7606
Practice Address - Street 1:800 CELEBRATION AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-4999
Practice Address - Country:US
Practice Address - Phone:407-566-1815
Practice Address - Fax:321-939-7606
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMFT 1395106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist