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Individual

DWIGHT M. RICHARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1421 PARKER CT, SPRINGFIELD, OH 45504-2855
(513) 941-4999
(513) 694-0168
Mailing address
6460 HARRISON AVE STE 200, CINCINNATI, OH 45247-7958
(513) 941-4999
(513) 694-0168

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
965713
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.965713
OH
101YM0800X
Mental Health Counselor
E.0003239
OH
101YP2500X
Professional Counselor
E.0003239
OH
101YP2500X
Professional Counselor
Primary
E.0003239-SUPV
OH
104100000X
Social Worker
S.0021026
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0215462
OH
Enumeration date
09/17/2014
Last updated
05/10/2023
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