Healthcare Provider Details
I. General information
NPI: 1124658752
Provider Name (Legal Business Name): RICHERT COUNSELING, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/23/2020
Last Update Date: 11/29/2020
Certification Date: 11/29/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1589 MAIN ST STE A
DUNEDIN FL
34698-4653
US
IV. Provider business mailing address
1016 VINEYARD CT
DUNEDIN FL
34698-6321
US
V. Phone/Fax
- Phone: 727-203-4987
- Fax: 727-205-4492
- Phone: 727-202-4987
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
A
RICHERT
Title or Position: OWNER
Credential: LMHC
Phone: 727-203-4987