Provider Demographics
NPI:1982095212
Name:WHEELER, RICHARD LOUIS (LPCC,TCADC,NCC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LOUIS
Last Name:WHEELER
Suffix:
Gender:M
Credentials:LPCC,TCADC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 MOCKINGBIRD HILL DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8007
Mailing Address - Country:US
Mailing Address - Phone:859-785-1030
Mailing Address - Fax:
Practice Address - Street 1:160 MOORE DR STE 201
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2936
Practice Address - Country:US
Practice Address - Phone:859-785-1030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-09
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY169402101YA0400X
KY174040101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100488590Medicaid