Davidson, Richard David
Davidson, Richard David is an sole proprietor health care provider with primary practice located at 3718 S Elm Pl Suite 3718, Broken Arrow OK 74011-1803. He recently has 5 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Rehabilitation, Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Cognitive & Behavioral. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Davidson, Richard David can be contacted via phone (918) 994-1510.Contact Information
Primary practice address
3718 S Elm Pl Suite 3718
Broken Arrow OK 74011-1803
Phone: (918) 994-1510
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | ||
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | ||
| Behavioral Health & Social Service Providers / Rehabilitation | 103TR0400X | ||
| Behavioral Health & Social Service Providers / Counseling | 103TC1900X | ||
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X |
Profile Details
| NPI number | 1992983407 |
|---|---|
| LBN Legal business name | Davidson, Richard David |
| Credentials | MS, LADC, CRC, CVRT, |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 6th, 2008 |
| Last updated | Aug 25th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992983407 | NPPES |
| Oklahoma | MEDICAID | 1992983407 |
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