MEDICARE: OLLIE ROCHELLE 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	101YP2500X	Professional Counselor		GA

General Provider Information

NPI Number	:	1679418396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLLIE ROCHELLE RICHARDS

Provider Business Mailing Address
First Line	:	121 CARL VINSON PKWY
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-5817
Country	:	US
Telephone Number	:	478-922-2365
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 CARL VINSON PKWY
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31088-5817
Country	:	US
Telephone Number	:	478-922-2365
Fax Number	:

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

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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Directions to “ OLLIE ROCHELLE RICHARDS ” Practice Location

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