Provider Demographics
NPI:1831229020
Name:WILEY, RICHARD D (LPC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:D
Last Name:WILEY
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 1:11999 KATY FWY
Mailing Address - Street 2:SUITE 385
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-1611
Mailing Address - Country:US
Mailing Address - Phone:281-597-9291
Mailing Address - Fax:281-597-9761
Practice Address - Street 1:11999 KATY FWY
Practice Address - Street 2:SUITE 385
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1611
Practice Address - Country:US
Practice Address - Phone:281-597-9291
Practice Address - Fax:281-597-9761
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15824101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional