Provider Demographics
NPI:1336325059
Name:WHITE, RICHARD L (LPC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:L
Last Name:WHITE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 PLAINVIEW ST
Mailing Address - Street 2:BUILDING C, SUITE 3
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1989
Mailing Address - Country:US
Mailing Address - Phone:713-941-3028
Mailing Address - Fax:713-941-3029
Practice Address - Street 1:3325 PLAINVIEW ST
Practice Address - Street 2:BUILDING C, SUITE 3
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1989
Practice Address - Country:US
Practice Address - Phone:713-941-3028
Practice Address - Fax:713-941-3029
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10305101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2882LCOtherBLUE CROSS BLUE SHIELD
TX026647001Medicaid