Richard E Cleveland, PHD, LPC, NCC, ACS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC010050 Issued in GA

Practice address

333 Pebble Stone TRL
Statesboro, GA 30461-1309

Phone

(912) 681-9009

NPI assigned

Sep 30, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569801600000",
    "number": "1851932073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 PEBBLE STONE TRL",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304611309",
            "telephone_number": "912-681-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 PEBBLE STONE TRL",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304611309",
            "telephone_number": "912-681-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEVELAND",
        "first_name": "RICHARD",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, NCC, ACS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-30",
        "last_updated": "2019-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC010050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Statesboro, GA
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.