RICHARD RUSSELL PROVENCIAL


Address: 5360 S Elati St Apt 6, Littleton, CO 80120-1527
Phone: 7202498862

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 5360 S ELATI ST APT 6
City LITTLETON
State CO
Zip Code 80120-1527

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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Competitor

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City LITTLETON
Zip Code 80120

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Dataset Information

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.

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