Individual
RICHARD THOMAS BASTUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S., CAS
Contact information
Practice address
7215 W 46TH PL, WHEAT RIDGE, CO 80033-3401
(720) 961-3511
Mailing address
7215 W 46TH PL, WHEAT RIDGE, CO 80033-3401
(914) 400-6993
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACC.0998499
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0733486274
HPSO
CO
01
—
ACC.0998499
DORA
CO
Enumeration date
07/29/2022
Last updated
07/29/2022
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