Healthcare Provider Details

I. General information

NPI: 1124378880
Provider Name (Legal Business Name): NICOLE RICHARDSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3532 BEE CAVES RD STE 101
WEST LAKE HILLS TX
78746-5466
US

IV. Provider business mailing address

3532 BEE CAVES RD STE 101
WEST LAKE HILLS TX
78746-5466
US

V. Phone/Fax

Practice location:
  • Phone: 512-698-9759
  • Fax:
Mailing address:
  • Phone: 512-698-9759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: