Phylis B Richard, LPC
Individual provider Active NPI Professional Counselor · Thibodaux, LA
NPI 1700208147 · NPPES record last updated Aug 19, 2015
Key facts
- NPI
- 1700208147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 3678 (LA)
- Practice address
- 102 W 5TH St
Thibodaux, LA 70301-3120 - Phone
- (985) 413-5137
- Fax
- (985) 413-5137
- NPI assigned
- Jan 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3678 | LA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 2ND Chance Counseling | Professional | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3678 | LA | Yes |
Addresses
Primary practice location
102 W 5TH St
Thibodaux, LA 70301-3120
Mailing address
316 Brandywine Blvd
Thibodaux, LA 70301-6157
Phone (985) 413-5137
Other providers in Thibodaux, LA
- Richard a Morvant Jr MD Apmc
- Brooke Richard
- Jennifer Richard
- Lacey C Richard
- Lanny Joseph Richard
- Shakara Richard
- Ashli Richardson
- Bre'Aishala Richardson
- Victoria Rideau
- William Sledge Riggins Jr.
All providers in Thibodaux, LA · Professional Counselor in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.