Provider Demographics
NPI:1659502060
Name:WHEELER, RICHARD MYRLE (LPC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:MYRLE
Last Name:WHEELER
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 1:1070 SHERRY LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2026
Mailing Address - Country:US
Mailing Address - Phone:717-341-5904
Mailing Address - Fax:717-892-1547
Practice Address - Street 1:1070 SHERRY LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2026
Practice Address - Country:US
Practice Address - Phone:717-341-5904
Practice Address - Fax:717-892-1547
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA367084101YA0400X
PAPC004781101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)