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Individual
RICHARD POVILAITIS
Active
Individual
RICHARD POVILAITIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CT0002715
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11244097
CAQH
CT
01
—
CT002715
LICENSE
CT
Enumeration date
05/13/2007
Last updated
07/08/2007
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