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Carlos De'Wayne Richardson, LPC

Counselor, Professional in Birmingham, AL. Individual provider (NPI-1).

NPI number1083133003
StatusActive
Last updated in NPPESJan 14, 2019

Details

NPI
1083133003
Entity type
Individual (NPI-1)
Name
Mr. Carlos De'Wayne Richardson
Credential
LPC
Sex
Male
Sole proprietor
No
Enumeration date
Sep 11, 2017
Last updated
Jan 14, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YP2500X Counselor, Professional3843ALYes
101YM0800X Counselor, Mental HealthC2131AAL

Practice location

100 Century Park S Ste 102
Birmingham, AL 35226-3922

Phone 205-565-6554 · Fax 888-386-9624

Mailing address

100 Century Park S Ste 102
Birmingham, AL 35226-3922

Phone 205-565-6554 · Fax 888-386-9624

Other practice locations

156 Mayfair Ln
Calera, AL 35040-5598

Phone 205-306-2866

4204 Edmonton Dr
Bessemer, AL 35022-4878

Phone 205-425-1200 · Fax 205-425-9606

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