Provider Demographics
NPI:1912994245
Name:BOND, RICHARD (MSW)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:BOND
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-3533
Mailing Address - Country:US
Mailing Address - Phone:412-969-7464
Mailing Address - Fax:
Practice Address - Street 1:629 WALNUT ST
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-3533
Practice Address - Country:US
Practice Address - Phone:412-969-7464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW008936L104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1325157OtherBLUE CROSS