MEDICARE: MRS. RICHELLE WHITTAKER I LPC

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
1	101YP2500X	Professional Counselor	64015	TX

General Provider Information

NPI Number	:	1902136815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RICHELLE WHITTAKER I LPC

Provider Business Mailing Address
First Line	:	11313 WINDY DAWN DR
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-8216
Country	:	US
Telephone Number	:	713-436-3532
Fax Number	:

Provider Business Practice Location Address
First Line	:	4660 BEECHNUT ST STE 220
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-1817
Country	:	US
Telephone Number	:	832-767-0760
Fax Number	:	832-553-7274

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2009
Last Update Date	:	07/16/2019

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Directions to “ MRS. RICHELLE WHITTAKER I LPC” Practice Location

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