Provider Demographics
NPI:1457909301
Name:SHUR, RICHARD PERSAUD (PSYD, CAADC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:PERSAUD
Last Name:SHUR
Suffix:
Gender:M
Credentials:PSYD, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 TEDWILL RD
Mailing Address - Street 2:
Mailing Address - City:FOUNTAINVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18923-9712
Mailing Address - Country:US
Mailing Address - Phone:215-589-8082
Mailing Address - Fax:
Practice Address - Street 1:10 S CLINTON ST STE 201
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4220
Practice Address - Country:US
Practice Address - Phone:215-589-8082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
PAPS019427103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)