Provider Demographics
NPI:1851625842
Name:AUSTIN, RICHARD B (MSW, LICSW)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:B
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 ROCKEFELLER AVE # MS 305
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4071
Mailing Address - Country:US
Mailing Address - Phone:425-388-7214
Mailing Address - Fax:
Practice Address - Street 1:3000 ROCKEFELLER AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4046
Practice Address - Country:US
Practice Address - Phone:425-388-7215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC 00034271101YM0800X
WALW602122961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health