RICHARD RUSSELL PROVENCIAL (NPI# 1538790134) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538790134 |
| Entity Type | Individual |
| Full Name | RICHARD RUSSELL PROVENCIAL |
| Credential | CAC II |
| Practice Address |
5360 S Elati St Apt 6 Littleton CO 80120-1527 |
| Practice Telephone | 7202498862 |
| Mailing Telephone | 7202498862 |
| Enumeration Date | 2020-02-01 |
| Last Update Date | 2020-02-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
ACB0008145 | CO | Behavioral Health & Social Service Providers |
| Street Address |
5360 S ELATI ST APT 6 |
| City | LITTLETON |
| State | CO |
| Zip Code | 80120-1527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156303 | Kelly Joy Brutsch | Counselor | 8191 Southpark Lane Suite 201, Littleton, CO 80120 | 2019-10-18 |
| 1902468309 | Infiniti Counseling, LLC | Clinic/Center | 4 W Dry Creek Circle, Littleton, CO 80120 | 2019-07-05 |
| 1437642642 | Brent Charles Mowery | Dentist | 209 W Littleton Blvd Ste B, Littleton, CO 80120 | 2018-06-12 |
| 1225525066 | Christopher Charles Miller | Counselor | 7851 S. Elati St., Suite 203, Littleton, CO 80120 | 2018-04-17 |
| 1417455890 | Cynthia Cline Mcrae | Counselor | 7921 Southpark Plaza, Grace Counseling, Suite 204, Littleton, CO 80120 | 2018-01-31 |
| 1780113175 | Janine Marie Lopez | Case Manager/Care Coordinator | 5500 S Sycamore, Littleton, CO 80120 | 2017-06-08 |
| 1952845588 | Hilary Sparrow Morris | Counselor | 991 Southpark Drive, #200, Cerescan, Littleton, CO 80120 | 2016-12-16 |
| 1760837132 | Supported Change,llc | Social Worker | 609 W Littleton Blvd Suite 201, Littleton, CO 80120 | 2016-05-04 |
| 1598123994 | Jarod Williams | Counselor | 8151 Southpark Ln Unit 250, Littleton, CO 80120 | 2016-02-01 |
| 1770948085 | Susan Jean Sylvester | Counselor | 609 West Littleton Blvd., Suite 201, Littleton, CO 80120 | 2015-12-31 |
| Find all providers in zip 80120 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497361646 | Jessica A Olguin | Counselor | 6901 S Pierce St Ste 337, Littleton, CO 80128-7202 | 2020-09-22 |
| 1588289193 | Planted Recovery Inc | Counselor | 801 W Mineral Ave Ste 201, Littleton, CO 80120-5663 | 2020-06-09 |
| 1770117681 | Debra J. Towle | Counselor | 11 Riverglen Ln Ste 100, Littleton, NH 03561-5748 | 2020-02-29 |
| 1700391018 | Monica Pineda | Counselor | 445 W Berry Ave, Littleton, CO 80120-1601 | 2017-12-08 |
| 1275050239 | Alyce Sebring | Counselor | 5554 S Prince St Ste 211, Littleton, CO 80120-1147 | 2017-08-29 |
| 1538683156 | Jennessa Marie Mcquade | Counselor | 18 Woodridge Rd, Littleton, MA 01460-2201 | 2017-07-26 |
| 1518409515 | Peter Beagen | Counselor | 31 Shattuck St, Littleton, MA 01460-1263 | 2016-11-08 |
| 1154787596 | Donna Gardner | Counselor | 69 Great Rd, Littleton, MA 01460 | 2016-01-14 |
| 1437549300 | Amber Brookman | Counselor | 6159 S Fenton Ct, Littleton, CO 80123-6827 | 2015-01-30 |
| 1780009886 | Lucille Amero | Counselor | 458 Old Waterford Rd, Littleton, NH 03561-3824 | 2014-02-26 |
| Find all providers in LITTLETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.