Healthcare Provider Details

I. General information

NPI: 1225004781
Provider Name (Legal Business Name): RICHARD JOSEPH HUMBLE MS DMIN LPC LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406A N 4TH
ODESSA MO
64076
US

IV. Provider business mailing address

PO BOX 543
LEXINGTON MO
64067
US

V. Phone/Fax

Practice location:
  • Phone: 660-232-4004
  • Fax: 660-259-2921
Mailing address:
  • Phone: 660-232-4004
  • Fax: 660-259-2921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2002032312
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number300100
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: