Healthcare Provider Details

I. General information

NPI: 1063903508
Provider Name (Legal Business Name): IESHA RENEE RICHARDS LPC, LMHC, MAC, CEAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2018
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8151 NEW LA GRANGE RD
LOUISVILLE KY
40222-4685
US

IV. Provider business mailing address

8151 NEW LA GRANGE RD
LOUISVILLE KY
40222-4685
US

V. Phone/Fax

Practice location:
  • Phone: 502-533-5288
  • Fax: 502-688-6149
Mailing address:
  • Phone: 502-533-5288
  • Fax: 502-688-6149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH15020
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number589
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number247831
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC14480
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: