Richard Russell Provencial, CAS
Richard Russell Provencial, CAS is an Addiction (Substance Use Disorder) Counselor in Aurora, Colorado. Practices as a sole proprietor. Licensed in Colorado.
- Licensed in
- CO
- In the registry since
- 2020
Practice location Address checks out
2993 S Peoria St Ste G5Aurora, CO 80014-5705
Phone: (720) 249-8862
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X · Licence ACC.0998145 (CO) |
|---|
Record details
| NPI number | 1538790134 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | CAS |
| Sole proprietor | Yes |
| NPI enumerated | February 1, 2020 |
| Last updated in NPPES | November 6, 2024 |
| Certification date | November 6, 2024 |
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