Provider Demographics
NPI:1972651347
Name:BALKIN, RICHARD SCOTT (PHD, LPC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:SCOTT
Last Name:BALKIN
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 HIDDEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-2531
Mailing Address - Country:US
Mailing Address - Phone:972-542-9571
Mailing Address - Fax:
Practice Address - Street 1:2750 VIRGINIA PKWY
Practice Address - Street 2:SUITE 108
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-4916
Practice Address - Country:US
Practice Address - Phone:972-542-8144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18551101YP2500X
ARP9911025101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional