Provider Demographics
NPI:1053425652
Name:RICHARD A GEORGE PHD INC
Entity type:Organization
Organization Name:RICHARD A GEORGE PHD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST PRESIDENT OF CORP
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:330-492-9913
Mailing Address - Street 1:3118 CLEVELAND AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-2813
Mailing Address - Country:US
Mailing Address - Phone:330-492-9913
Mailing Address - Fax:330-492-6561
Practice Address - Street 1:3118 CLEVELAND AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-2813
Practice Address - Country:US
Practice Address - Phone:330-492-9913
Practice Address - Fax:330-492-6561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OH103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty