Individual
MR. RICHARD STEPHEN WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY. D
Contact information
Practice address
650 LINCOLN ST, WORCESTER, MA 01605-2060
(508) 595-0750
(508) 595-1130
Mailing address
650 LINCOLN ST, WORCESTER, MA 01605-2060
(508) 532-2200
(508) 853-8593
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
10058
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101YA0400X
—
CA
Enumeration date
09/03/2010
Last updated
04/03/2017
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