Provider Demographics
NPI:1043558091
Name:MCBRIDE, RICHARD RAY (LPCS, LPC, MAC, CCS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:RAY
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:LPCS, LPC, MAC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 S CASHUA DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-6323
Mailing Address - Country:US
Mailing Address - Phone:843-673-0660
Mailing Address - Fax:843-679-5666
Practice Address - Street 1:1430 S CASHUA DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-6323
Practice Address - Country:US
Practice Address - Phone:843-673-0660
Practice Address - Fax:843-679-5666
Is Sole Proprietor?:No
Enumeration Date:2013-01-26
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5676101YP2500X
TX7579101YA0400X
SC508445101YA0400X
SC1311266101YA0400X
SC3408101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)