MEDICARE: KATE RICHARDSON CMHC

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	101YM0800X	Mental Health Counselor	140457086004	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093399313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATE RICHARDSON CMHC

Provider Business Mailing Address
First Line	:	574 W 3150 S
Second Line	:
City	:	SYRACUSE
State	:	UT
Zip	:	84075-8061
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	574 W 3150 S
Second Line	:
City	:	SYRACUSE
State	:	UT
Zip	:	84075-8061
Country	:	US
Telephone Number	:	801-781-0317
Fax Number	:

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

Provider Enumeration Date	:	05/12/2021
Last Update Date	:	03/18/2026

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