Provider Demographics
NPI:1831746528
Name:RICHARDSON, NICOLE TUREE EVANS (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:TUREE EVANS
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:TUREE
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2813 BARKSDALE DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-6045
Mailing Address - Country:US
Mailing Address - Phone:972-505-9530
Mailing Address - Fax:
Practice Address - Street 1:1700 ALMA DR STE 305
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6956
Practice Address - Country:US
Practice Address - Phone:972-505-9530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-19
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
TX83502101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83502OtherTX LPC LICENSE