Provider Demographics
NPI:1376353565
Name:STURTEVANT, RICHARD J JR
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:J
Last Name:STURTEVANT
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3634
Mailing Address - Country:US
Mailing Address - Phone:774-317-0872
Mailing Address - Fax:
Practice Address - Street 1:333 TURNPIKE ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:SOUTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01772
Practice Address - Country:US
Practice Address - Phone:888-329-4535
Practice Address - Fax:844-965-9105
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician