Provider Demographics
NPI:1548473440
Name:LAWSON, RICHARD ALEXANDER (MS)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:ALEXANDER
Last Name:LAWSON
Suffix:
Gender:M
Credentials:MS
Other - Prefix:MR
Other - First Name:RICK
Other - Middle Name:
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:3152 WINTERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-0711
Mailing Address - Country:US
Mailing Address - Phone:219-462-1040
Mailing Address - Fax:219-462-1040
Practice Address - Street 1:1101 GLENDALE BLVD STE 101-B
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-3775
Practice Address - Country:US
Practice Address - Phone:219-462-1040
Practice Address - Fax:219-462-1040
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34002466A1041C0700X
IN33001469A104100000X
IN39000438A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker