Provider Demographics
NPI:1134214224
Name:SPRING, RICHARD (PHD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:SPRING
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 WESTMORELAND PL
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-4721
Mailing Address - Country:US
Mailing Address - Phone:731-217-3261
Mailing Address - Fax:731-421-2778
Practice Address - Street 1:156 W UNIVERSITY PKWY
Practice Address - Street 2:STE B
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1617
Practice Address - Country:US
Practice Address - Phone:731-217-3261
Practice Address - Fax:731-421-2778
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN618103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2008079OtherBLUE CROSS BLUE SHIELD #
TN2008079OtherBLUE CROSS BLUE SHIELD #