Provider Demographics
NPI:1750680476
Name:LONNIE RICHARDSON COUNSELING SERVICES,LLC
Entity Type:Organization
Organization Name:LONNIE RICHARDSON COUNSELING SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:LONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:MS
Authorized Official - Phone:251-593-9611
Mailing Address - Street 1:PO BOX 159
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36461-0159
Mailing Address - Country:US
Mailing Address - Phone:251-593-9611
Mailing Address - Fax:251-743-3451
Practice Address - Street 1:307 E CLAIBORNE ST
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36460-1919
Practice Address - Country:US
Practice Address - Phone:251-593-9611
Practice Address - Fax:251-743-3451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-21
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC1743A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty