Healthcare Provider Details

I. General information

NPI: 1609851062
Provider Name (Legal Business Name): GREGG RANKIN RICHARDS LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2005
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 W CENTER ST STE 203
MARION OH
43302-3741
US

IV. Provider business mailing address

1189 YORKSHIRE DR
MARION OH
43302-6861
US

V. Phone/Fax

Practice location:
  • Phone: 740-223-5624
  • Fax: 740-375-6329
Mailing address:
  • Phone: 740-396-0093
  • Fax: 614-291-3800

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberE-2050
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: