Healthcare Provider Details

I. General information

NPI: 1669675450
Provider Name (Legal Business Name): LORI RICHARDSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 07/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 RIDGEFIELD BLVD STE 250
ASHEVILLE NC
28806-2287
US

IV. Provider business mailing address

1502 W NC HIGHWAY 54 STE 103
DURHAM NC
27707-5572
US

V. Phone/Fax

Practice location:
  • Phone: 828-633-6070
  • Fax: 828-633-6073
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberSW7040
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC008381
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: