Healthcare Provider Details

I. General information

NPI: 1548565187
Provider Name (Legal Business Name): TERI J RICHARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2011
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 OLD SANTA FE TRL # 603
SANTA FE NM
87505-0398
US

IV. Provider business mailing address

518 OLD SANTA FE TRL # 603
SANTA FE NM
87505-0398
US

V. Phone/Fax

Practice location:
  • Phone: 505-490-0167
  • Fax:
Mailing address:
  • Phone: 505-490-0167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0111721
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCCMH0159331
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: