Individual
MR. RICHARD ANTHONY DISTAULO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW, LCADC
Contact information
Practice address
95 MOUNT KEMBLE AVE, MORRISTOWN, NJ 07960-5155
(888) 247-1400
(973) 290-7585
Mailing address
95 MT. KEMBLE AVENUE, ATTN: C. LAMPRON, MORRISTOWN, NJ 07962-1978
(973) 971-4714
(973) 290-7585
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00067600
NJ
1041C0700X
Clinical Social Worker
44SC01344600
NJ
Other
Enumeration date
08/16/2006
Last updated
09/11/2025
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