Provider Demographics
NPI:1922154004
Name:AMISS, RICHARD (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:AMISS
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 MISSION RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78210-4501
Mailing Address - Country:US
Mailing Address - Phone:210-533-1203
Mailing Address - Fax:210-533-6199
Practice Address - Street 1:919 MISSION RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78210-4501
Practice Address - Country:US
Practice Address - Phone:210-533-1203
Practice Address - Fax:210-533-6199
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16808101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional