Provider Demographics
NPI:1821143512
Name:PENDLETON, RICHARD RAY SR (MS, LIMHP, LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:RAY
Last Name:PENDLETON
Suffix:SR
Gender:M
Credentials:MS, LIMHP, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 519
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-0519
Mailing Address - Country:US
Mailing Address - Phone:308-324-6754
Mailing Address - Fax:
Practice Address - Street 1:307 E 5TH ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850-2110
Practice Address - Country:US
Practice Address - Phone:308-324-6754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1876101YM0800X
NE3534101YM0800X
NELIMHP 1050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health