Provider Demographics
NPI:1205363835
Name:HELTON, RICHARD
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:HELTON
Suffix:
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 1:569 BIGELOW RD
Mailing Address - Street 2:
Mailing Address - City:BLEDSOE
Mailing Address - State:KY
Mailing Address - Zip Code:40810-9200
Mailing Address - Country:US
Mailing Address - Phone:606-767-7002
Mailing Address - Fax:
Practice Address - Street 1:48 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9443
Practice Address - Country:US
Practice Address - Phone:606-487-7646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-13
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY172793101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)