Individual
MR. CARLOS DE'WAYNE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
100 CENTURY PARK S STE 102, BIRMINGHAM, AL 35226-3922
(205) 565-6554
(888) 386-9624
Mailing address
100 CENTURY PARK S STE 102, BIRMINGHAM, AL 35226-3922
(205) 565-6554
(888) 386-9624
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C2131A
AL
101YP2500X
Professional Counselor
Primary
3843
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46--1731139
—
AL
01
—
46-1731139
OTHER
AL
Enumeration date
09/11/2017
Last updated
01/14/2019
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