Healthcare Provider Details

I. General information

NPI: 1871870733
Provider Name (Legal Business Name): JOANNE ELIZABETH RICHMOND BCPC, L.CSW-R, FAPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2011
Last Update Date: 11/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N MAIN AVE
ALBANY NY
12203-1410
US

IV. Provider business mailing address

30 N MAIN AVE
ALBANY NY
12203-1410
US

V. Phone/Fax

Practice location:
  • Phone: 518-453-6743
  • Fax: 518-453-6733
Mailing address:
  • Phone: 518-453-6743
  • Fax: 518-453-6733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR040897-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number559445941
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: