Provider Demographics
NPI:1942214440
Name:KOENIG, RICHARD W (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:W
Last Name:KOENIG
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 MARCHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-6105
Mailing Address - Country:US
Mailing Address - Phone:610-524-9060
Mailing Address - Fax:610-524-1211
Practice Address - Street 1:47 MARCHWOOD RD
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-6105
Practice Address - Country:US
Practice Address - Phone:610-524-9060
Practice Address - Fax:610-524-1211
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004594L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist