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NPI Code Detail

MEDICARE: CONNIE J RICHTER LCSW

MEDICARE: CONNIE J RICHTER LCSW
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
1104100000XSocial Worker1788KY
21041C0700XClinical Social Worker34005525AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000547020OTHERINANTHEM

General Provider Information

NPI Number : 1427150044
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONNIE J RICHTER LCSW
Provider Business Mailing Address
First Line : 4925 CHARLESTOWN RD
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-9426
Country : US
Telephone Number : 812-941-9200
Fax Number : 812-941-9205
Provider Business Practice Location Address
First Line : 4925 CHARLESTOWN RD
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-9426
Country : US
Telephone Number : 812-941-9200
Fax Number : 812-941-9205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2006
Last Update Date : 09/03/2014

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Directions to “ CONNIE J RICHTER LCSW” Practice Location

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