Provider Demographics
NPI:1457598666
Name:BEAN, RICHARD SCOTT (LMHC)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:SCOTT
Last Name:BEAN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6312 MONTANO RD NW
Mailing Address - Street 2:STE A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-2170
Mailing Address - Country:US
Mailing Address - Phone:505-717-1155
Mailing Address - Fax:505-717-1155
Practice Address - Street 1:6312 MONTANO RD NW
Practice Address - Street 2:STE A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-2170
Practice Address - Country:US
Practice Address - Phone:505-717-1155
Practice Address - Fax:505-717-1155
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM111401101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health