Provider Demographics
NPI:1285130377
Name:HOLDEN, RICHARD J (LADC, LCSW)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:J
Last Name:HOLDEN
Suffix:
Gender:M
Credentials:LADC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:73 CANTON RD
Mailing Address - Street 2:
Mailing Address - City:WEST SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06092-2808
Mailing Address - Country:US
Mailing Address - Phone:860-651-6402
Mailing Address - Fax:
Practice Address - Street 1:33 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-6329
Practice Address - Country:US
Practice Address - Phone:860-618-5858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000149101YA0400X
CT00054541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)