Provider Demographics
NPI:1063747764
Name:ALLEN, RICHARD G (PSYD, BCBA-D, NCSP)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
Last Name:ALLEN
Suffix:
Gender:M
Credentials:PSYD, BCBA-D, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 KINGS CT
Mailing Address - Street 2:
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-5033
Mailing Address - Country:US
Mailing Address - Phone:856-264-6099
Mailing Address - Fax:
Practice Address - Street 1:510 PHILADELPHIA PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-2100
Practice Address - Country:US
Practice Address - Phone:877-834-9302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-14
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-06-3160103K00000X
DEB1-0001038103TC0700X
NJ35100664700103TC0700X
PAPS017761103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst