Provider Demographics
NPI:1124308218
Name:UVA, RICHARD L (LMHC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:UVA
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 NEW STATE HWY
Mailing Address - Street 2:SUITE SIX
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-1433
Mailing Address - Country:US
Mailing Address - Phone:508-880-6868
Mailing Address - Fax:508-880-6864
Practice Address - Street 1:90 NEW STATE HWY
Practice Address - Street 2:SUITE SIX
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-1433
Practice Address - Country:US
Practice Address - Phone:508-880-6868
Practice Address - Fax:508-880-6864
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7450101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health