Individual provider Active NPI

Wynne Richardson

  • Professional Counselor
  • Wichita Falls, TX
National Provider Identifier
1588450704
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
74691 Issued in TX
Practice address
2501 Taylor St
Wichita Falls, TX 76309-5341
Phone
(940) 761-3034
NPI assigned
Apr 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 10110 TX
Professional Counselor 101YP2500X 74691 TX Primary

Addresses

Primary practice location

2501 Taylor St
Wichita Falls, TX 76309-5341

Mailing address

2501 Taylor St
Wichita Falls, TX 76309-5341
Phone (940) 761-3034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250710001289 TX Practitioner - Mental Health Counselor 8022522051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Micah Boyer MDGroup PAC ID 8426482159, 15 clinicians

Practice addresses (Care Compare)

1921 9TH St
Wichita Falls, TX 76301-4129
Phone (940) 397-5431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10110TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Micah Boyer MD CurrentSince Jun 2, 2025 Accepting new patients
Ruelas Management Services, LLC PastSince Apr 20, 2025 Accepting new patients

Locations

1921 9th St
Wichita Falls, TX 76301
Phone (940) 322-8475

500 N Scott Ave
Wichita Falls, TX 76306
Phone (940) 228-1879

3901 Armory Rd
Wichita Falls, TX 76302
Phone (940) 397-5431

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1588450704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 TAYLOR ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763095341",
            "telephone_number": "940-761-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 TAYLOR ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763095341",
            "telephone_number": "940-761-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "WYNNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "10110",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "74691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.