Provider Demographics
NPI:1588689400
Name:STATON, RICHARD CHRISTOPHER (MSW LICSW CERTIFICAT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:CHRISTOPHER
Last Name:STATON
Suffix:
Gender:M
Credentials:MSW LICSW CERTIFICAT
Other - Prefix:MR
Other - First Name:KIT
Other - Middle Name:
Other - Last Name:STATON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:23 NORTH RD
Mailing Address - Street 2:LILY PADS PROFESSIONAL CENTER SUITE A-11
Mailing Address - City:PEACE DALE
Mailing Address - State:RI
Mailing Address - Zip Code:02879-2176
Mailing Address - Country:US
Mailing Address - Phone:401-782-4044
Mailing Address - Fax:
Practice Address - Street 1:23 NORTH RD
Practice Address - Street 2:LILY PADS PROFESSIONAL CENTER SUITE A-11
Practice Address - City:PEACE DALE
Practice Address - State:RI
Practice Address - Zip Code:02879-2176
Practice Address - Country:US
Practice Address - Phone:401-782-4044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW002201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical