Provider Demographics
NPI:1245596840
Name:OSMAN, RICHARD A JR (MS, LPC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:A
Last Name:OSMAN
Suffix:JR
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12415 HERITAGE MEADOWS DR.
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585
Mailing Address - Country:US
Mailing Address - Phone:815-254-8028
Mailing Address - Fax:
Practice Address - Street 1:24012 W. RENWICK RD., STE. 204A
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544
Practice Address - Country:US
Practice Address - Phone:815-676-4688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178006051101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health