| Doctor Name: | MR. RICHARD S ATWATER |
| NPI Number: | 1104012731 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCPC |
| License Number: | |
| Business Practice Address: | 101 N Virginia St Suite 110 Crystal Lake, IL - 600143426 |
| Business Phone Number: | 8154590499 |
| Business Fax Number: | 8157880115 |
| Mailing Address: | 101 N Virginia St, Suite 110 CRYSTAL LAKE |
| State: | IL |
| Postal Code: | 600143426 |
| Phone Number: | 8154590499 |
| Fax Number: | 8157880115 |
| NPI Enumeration Date: | 09/18/2007 |
| NPI Last Update Date: | 09/18/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |