| Doctor Name: | MR. RICHARD PHELPS |
| NPI Number: | 1174977375 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 1099 Northside Shopping Ctr Oneida, NY - 134214901 |
| Business Phone Number: | 1315363245 |
| Business Fax Number: | |
| Mailing Address: | 1099 Northside Shopping Ctr, ONEIDA |
| State: | NY |
| Postal Code: | 134214901 |
| Phone Number: | 3153632451 |
| Fax Number: | |
| NPI Enumeration Date: | 04/14/2016 |
| NPI Last Update Date: | 04/14/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |