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NPI Code Detail

MEDICARE: RICHARD CARROLL WHEAT MS, LPC, NCC

MEDICARE:   RICHARD CARROLL WHEAT  MS, LPC, NCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor2020011371OK
2101YP2500XProfessional Counselor74898TX

General Provider Information

NPI Number : 1386291425
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD CARROLL WHEAT MS, LPC, NCC
Provider Business Mailing Address
First Line : 5536 E 106TH PL
Second Line :
City : TULSA
State : OK
Zip : 74137-7089
Country : US
Telephone Number : 936-662-8580
Fax Number :
Provider Business Practice Location Address
First Line : 5536 E 106TH PL
Second Line :
City : TULSA
State : OK
Zip : 74137-7089
Country : US
Telephone Number : 936-662-8580
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2019
Last Update Date : 06/28/2020

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Directions to “ RICHARD CARROLL WHEAT MS, LPC, NCC” Practice Location

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