Healthcare Provider Details

I. General information

NPI: 1306771456
Provider Name (Legal Business Name): JULIE KIM RICHARDS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BRADHURST AVE
HAWTHORNE NY
10532-2140
US

IV. Provider business mailing address

366 CATSKILL CT
MAHWAH NJ
07430-2735
US

V. Phone/Fax

Practice location:
  • Phone: 914-493-2080
  • Fax: 914-493-2080
Mailing address:
  • Phone: 973-452-4154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number076007-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number076007-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: