Provider Demographics
NPI:1770062689
Name:HOUSEAL, RICHARD E JR (LCSW)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:E
Last Name:HOUSEAL
Suffix:JR
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 LAKES DR STE 225
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91790-2910
Mailing Address - Country:US
Mailing Address - Phone:302-668-6525
Mailing Address - Fax:
Practice Address - Street 1:406 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-2126
Practice Address - Country:US
Practice Address - Phone:302-668-6525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1002201041C0700X
DEQ1-00016341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA100220OtherCA BBS