MEDICARE: MYRTLE RICHARDS

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	017126	NY

General Provider Information

NPI Number	:	1477445609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYRTLE RICHARDS

Provider Business Mailing Address
First Line	:	619 LOCUST ST
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10552-2611
Country	:	US
Telephone Number	:	718-440-0574
Fax Number	:

Provider Business Practice Location Address
First Line	:	619 LOCUST ST
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10552-2611
Country	:	US
Telephone Number	:	718-440-0574
Fax Number	:

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

Provider Enumeration Date	:	07/21/2025
Last Update Date	:	02/03/2026

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Directions to “ MYRTLE RICHARDS ” Practice Location

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