Provider Demographics
NPI:1386963494
Name:RICHEY, DWIGHT (MS, LPC)
Entity type:Individual
Prefix:
First Name:DWIGHT
Middle Name:
Last Name:RICHEY
Suffix:
Gender:M
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 WESTBURY GLEN BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73179-1244
Mailing Address - Country:US
Mailing Address - Phone:405-919-8505
Mailing Address - Fax:
Practice Address - Street 1:8625 S WALKER AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-9462
Practice Address - Country:US
Practice Address - Phone:405-331-6913
Practice Address - Fax:405-635-1179
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7350101YP2500X, 101Y00000X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor