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NPI Code Detail

MEDICARE: MRS. DORINDA ANGELA GAYNELLE RICHBERG LMHC NCC

MEDICARE:  MRS. DORINDA ANGELA GAYNELLE RICHBERG  LMHC NCC
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
1390200000XStudent in an Organized Health Care Education/Training Program
2101YM0800XMental Health Counselor004735NY

General Provider Information

NPI Number : 1609930429
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DORINDA ANGELA GAYNELLE RICHBERG LMHC NCC
Provider Business Mailing Address
First Line : 63 COURT ST
Second Line :
City : WEST BABYLON
State : NY
Zip : 11704-2107
Country : US
Telephone Number : 917-478-3914
Fax Number :
Provider Business Practice Location Address
First Line : 275 BROADHOLLOW RD STE 120
Second Line :
City : MELVILLE
State : NY
Zip : 11747-4863
Country : US
Telephone Number : 845-279-5908
Fax Number : 845-622-5055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2006
Last Update Date : 04/13/2026

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Directions to “ MRS. DORINDA ANGELA GAYNELLE RICHBERG LMHC NCC” Practice Location

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