Provider Demographics
NPI:1346520657
Name:RICHARDS, EDWARD JAY (LPC)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JAY
Last Name:RICHARDS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3109 KNOX ST STE 510
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-4029
Mailing Address - Country:US
Mailing Address - Phone:214-766-9200
Mailing Address - Fax:214-528-4515
Practice Address - Street 1:6220 GASTON AVE STE 501
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-4354
Practice Address - Country:US
Practice Address - Phone:214-766-9200
Practice Address - Fax:214-528-4515
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX17031101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health