Individual provider Active NPI

Richard W Crandall, MA, LADC, NCC

  • Addiction (Substance Use Disorder) Counselor
  • Lebanon, NH
National Provider Identifier
1992971691
Registry record updated Nov 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
000419 Issued in VT
Practice address
9 Hanover St Ste 2
Lebanon, NH 03766-1312
Phone
(603) 448-0126
Fax
(603) 448-6001
NPI assigned
May 2, 2008
Last updated
Nov 24, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 000419 VT Primary

Addresses

Primary practice location

9 Hanover St Ste 2
Lebanon, NH 03766-1312

Mailing address

9 Hanover St Ste 2
Lebanon, NH 03766-1312
Phone (603) 448-0126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240305001530 VT Practitioner - Mental Health Counselor 7911342548 Practice locations: Windsor, VT

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

381 Estey LN
Windsor, VT 05089-9325
Phone (880) 267-4666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
000419VTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
West Central Services, Inc Past Accepting new patients
West Central Services, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227484800000",
    "number": "1992971691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 HANOVER ST STE 2",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661312",
            "telephone_number": "603-448-0126",
            "fax_number": "603-448-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 HANOVER ST STE 2",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661312",
            "telephone_number": "603-448-0126",
            "fax_number": "603-448-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "RICHARD",
        "middle_name": "W",
        "credential": "MA, LADC, NCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-02",
        "last_updated": "2008-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "000419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.