Individual provider Active NPI

Richard R Williams, MA, LPC, LAC

  • Addiction (Substance Use Disorder) Counselor
  • Pueblo, CO
National Provider Identifier
1902073448
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
ACD.0001138 Issued in CO
Practice address
1615 Bonforte Blvd
Pueblo, CO 81001-1602
Phone
(719) 404-1996
Fax
(719) 404-1992
NPI assigned
May 14, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACD.0001138 CO Primary
Mental Health Counselor 101YM0800X LPC.0015102 CO
Professional Counselor 101YP2500X LPC.0015102 CO

Addresses

Primary practice location

1615 Bonforte Blvd
Pueblo, CO 81001-1602

Mailing address

612 Field Ave
Canon City, CO 81212-2641
Phone (719) 371-8475

Other practice location 1

413 Spring St
Chattanooga, TN 37405-3848
Phone (423) 756-2740

Other practice location 2

612 Field Ave
Canon City, CO 81212
Phone (719) 371-8475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1026 Maxwell St
Colorado Springs, CO 80906-5554

612 Field Ave
Canon City, CO 81212-2641

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
ACD.0001138COMDAddiction (Substance Use Disorder) Counselor
LPC.0015102COMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Volunteer Behavioral Health Care System Past Accepting new patients

Organizations & group practices 1

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": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1902073448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 FIELD AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122641",
            "telephone_number": "719-371-8475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 BONFORTE BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810011602",
            "telephone_number": "719-404-1996",
            "fax_number": "719-404-1992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 Spring St",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374053848",
            "country_code": "US",
            "telephone_number": "423-756-2740",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "612 Field Ave",
            "address_purpose": "LOCATION",
            "city": "Canon City",
            "state": "CO",
            "postal_code": "81212",
            "country_code": "US",
            "telephone_number": "719-371-8475",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RICHARD",
        "middle_name": "R",
        "credential": "MA, LPC, LAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-14",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACD.0001138",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0015102",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0015102",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.