Richard Lee Wells

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2002020616 Issued in MO

Practice address

120 Brooks St Apt 17
Licking, MO 65542-8031

Phone

(573) 889-9534

NPI assigned

Jun 9, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1181347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1841493434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4449",
            "city": "WAYNESVILLE",
            "state": "MO",
            "postal_code": "655834449",
            "telephone_number": "573-889-9534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BROOKS ST APT 17",
            "city": "LICKING",
            "state": "MO",
            "postal_code": "655428031",
            "telephone_number": "573-889-9534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLS",
        "first_name": "RICHARD",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-09",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2002020616",
            "primary": true
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171R00000X",
            "taxonomy_group": "",
            "desc": "Interpreter",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "498829100",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. John'S Physician & Clinic (St. John's Sisk Pharmacy)
• Marley Ann Stephan, FNP
• Texas County Memorial Hospital (TCMH Family Clinic - Licking)
• Texas County Memorial Hospital (TCMH Family Clinic - Licking)
• Robin Sue Wallace, SLP
• Emily J Wiseman, FNP
• Joshua P Wolfe, MD

• Professional Counselor in Licking, MO
• Providers in Licking, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.