Provider Demographics
NPI:1841285053
Name:CONANT, RICHARD H (LPC)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:H
Last Name:CONANT
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 531
Mailing Address - Street 2:
Mailing Address - City:EAST WAKEFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03830-0531
Mailing Address - Country:US
Mailing Address - Phone:207-475-4156
Mailing Address - Fax:603-533-3312
Practice Address - Street 1:435 ROUTE 1
Practice Address - Street 2:STE 2
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904
Practice Address - Country:US
Practice Address - Phone:207-475-4156
Practice Address - Fax:603-522-3312
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10421101YP2500X
MECC3531101YP2500X
TX2415106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist