=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922252154
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RICK ALLEN SCHOLES JR. LPC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/14/2008
-----------------------------------------------------
Last Update Date | 11/14/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 284 S 205TH ST
-----------------------------------------------------
City | PITTSBURG
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66762-8522
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-347-4816
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 284 S 205TH ST
-----------------------------------------------------
City | PITTSBURG
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66762-8522
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 620-347-4816
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | LPC 876
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103TS0200X
-----------------------------------------------------
Taxonomy Name | School Psychologist
-----------------------------------------------------
License Number | 6445167659
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------