Provider Demographics
NPI:1689361032
Name:RICHARDS, DENISE (LPC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25681 PENDLETON FOREST RD
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63383-5477
Mailing Address - Country:US
Mailing Address - Phone:636-262-1137
Mailing Address - Fax:
Practice Address - Street 1:25681 PENDLETON FOREST RD
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:MO
Practice Address - Zip Code:63383-5477
Practice Address - Country:US
Practice Address - Phone:636-262-1137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO3610101YA0400X
MO2022032269101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)