Healthcare Provider Details

I. General information

NPI: 1538556345
Provider Name (Legal Business Name): MICHELLE RICHARDSON, LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2015
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 WHITE HORSE PIKE
HADDON HEIGHTS NJ
08035-1703
US

IV. Provider business mailing address

207 WHITE HORSE PIKE
HADDON HEIGHTS NJ
08035-1703
US

V. Phone/Fax

Practice location:
  • Phone: 856-617-4544
  • Fax:
Mailing address:
  • Phone: 609-238-9928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05386700
License Number StateNJ

VIII. Authorized Official

Name: MICHELLE RICHARDSON
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW, LCSW
Phone: 609-238-9928