Basic Information
| Provider Information | |||||||||
| NPI: | 1174781868 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ARMENTROUT | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | ARTHUR | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4498 KIMMEL RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432241131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142680653 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1115 BETHEL RD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432202690 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145380353 | ||||||||
| FaxNumber: | 6145861879 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2008 | ||||||||
| LastUpdateDate: | 05/29/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | C0600543 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.