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Individual
MR. RICHARD MICHAEL PRUSSIN
Active
Individual
MR. RICHARD MICHAEL PRUSSIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
PR014595-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11239539
CAQH
NY
01
—
146679
VALUEOPTIONS
NY
01
—
392979
MVP
NY
Enumeration date
09/04/2006
Last updated
11/01/2013
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