Provider Demographics
NPI:1932284767
Name:EBERLY, RICHARD L (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:EBERLY
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-8858
Mailing Address - Country:US
Mailing Address - Phone:540-434-3456
Mailing Address - Fax:540-432-1535
Practice Address - Street 1:1820 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-8858
Practice Address - Country:US
Practice Address - Phone:540-434-3456
Practice Address - Fax:540-432-1535
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701000668101Y00000X
VA0717000695106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA028916OtherVALUE OPTIONS
VA285311OtherANTHEM
VA083216OtherSENTARA