Healthcare Provider Details

I. General information

NPI: 1225587009
Provider Name (Legal Business Name): MEREDITH RICHARDS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2016
Last Update Date: 04/20/2020
Certification Date: 04/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 MAIN ST
DANIELSON CT
06239-2816
US

IV. Provider business mailing address

239 MAIN ST
DANIELSON CT
06239-2816
US

V. Phone/Fax

Practice location:
  • Phone: 860-315-3085
  • Fax:
Mailing address:
  • Phone: 860-315-3085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number9144
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1922
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number6533
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: