Doctor Name: | SCOTT W RICHARDSON |
NPI Number: | 1063847713 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC |
License Number: | 4484 |
Business Practice Address: | 55 Basin Creek Rd Butte, MT - 597019704 |
Business Phone Number: | 4064966314 |
Business Fax Number: | |
Mailing Address: | 82 Avista Vlg, NOXON |
State: | MT |
Postal Code: | 598539611 |
Phone Number: | 4068472955 |
Fax Number: | |
NPI Enumeration Date: | 09/12/2013 |
NPI Last Update Date: | 09/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 4484 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |