Provider Demographics
NPI:1457563777
Name:KRAFCIK, RICHARD P (LADC, LCSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:P
Last Name:KRAFCIK
Suffix:
Gender:M
Credentials:LADC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 MAIN ST
Mailing Address - Street 2:BLDG 3, SUITE 9
Mailing Address - City:PLANTSVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06479-1565
Mailing Address - Country:US
Mailing Address - Phone:203-288-2411
Mailing Address - Fax:866-400-1935
Practice Address - Street 1:710 MAIN ST
Practice Address - Street 2:BLDG 3, SUITE 9
Practice Address - City:PLANTSVILLE
Practice Address - State:CT
Practice Address - Zip Code:06479-1565
Practice Address - Country:US
Practice Address - Phone:203-288-2411
Practice Address - Fax:866-400-1935
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006256104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker