Provider Demographics
NPI:1891215877
Name:MALDONADO, RICHARD D (LPC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:D
Last Name:MALDONADO
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 1:108 PAGE AVE
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-4184
Mailing Address - Country:US
Mailing Address - Phone:830-778-3629
Mailing Address - Fax:830-778-3888
Practice Address - Street 1:108 PAGE AVE
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-4184
Practice Address - Country:US
Practice Address - Phone:830-778-3629
Practice Address - Fax:830-778-3888
Is Sole Proprietor?:No
Enumeration Date:2017-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59178101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional