Healthcare Provider Details

I. General information

NPI: 1831703917
Provider Name (Legal Business Name): JENNIFER M RICHARDS M.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2020
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8063 MADISON AVE # 511
INDIANAPOLIS IN
46227-6001
US

IV. Provider business mailing address

8063 MADISON AVE # 511
INDIANAPOLIS IN
46227-6001
US

V. Phone/Fax

Practice location:
  • Phone: 812-316-5140
  • Fax:
Mailing address:
  • Phone: 812-316-5140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: