MEDICARE: BETTY ANN RICHMOND LMHC

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	LH 0004236	WA

General Provider Information

NPI Number	:	1881730570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETTY ANN RICHMOND LMHC

Provider Business Mailing Address
First Line	:	753 N 35TH ST STE 301
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8873
Country	:	US
Telephone Number	:	206-633-2232
Fax Number	:	206-783-2179

Provider Business Practice Location Address
First Line	:	753 N 35TH ST STE 301
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8873
Country	:	US
Telephone Number	:	206-633-2232
Fax Number	:	206-783-2179

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

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	07/08/2007

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