Provider Demographics
NPI:1770523672
Name:LAOSA, RICHARD A (LPC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:LAOSA
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 1:2583 ADOBE VIS
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-2246
Mailing Address - Country:US
Mailing Address - Phone:830-372-1806
Mailing Address - Fax:877-936-3252
Practice Address - Street 1:2583 ADOBE VIS
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-2246
Practice Address - Country:US
Practice Address - Phone:830-372-1806
Practice Address - Fax:877-936-3252
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0880101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX025700802Medicaid