Provider Demographics
NPI:1013461227
Name:SALVESEN, RICHARD JR
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:SALVESEN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 OLD CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02346-1027
Mailing Address - Country:US
Mailing Address - Phone:774-263-2015
Mailing Address - Fax:
Practice Address - Street 1:105 OLD CENTER ST
Practice Address - Street 2:
Practice Address - City:MIDDLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02346-1027
Practice Address - Country:US
Practice Address - Phone:774-263-2015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health