Provider Demographics
NPI:1881709525
Name:RICHESON, PAUL E (LCSW,LMFT,LCDC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:E
Last Name:RICHESON
Suffix:
Gender:M
Credentials:LCSW,LMFT,LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 STAR RIDGE PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7429
Mailing Address - Country:US
Mailing Address - Phone:915-833-8311
Mailing Address - Fax:
Practice Address - Street 1:600 SUNLAND PARK DR
Practice Address - Street 2:BLDG. 6 STE. 400
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5115
Practice Address - Country:US
Practice Address - Phone:915-584-3636
Practice Address - Fax:915-587-0487
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320101YA0400X
TXS115841041C0700X
TX1014106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist