Healthcare Provider Details

I. General information

NPI: 1356287247
Provider Name (Legal Business Name): ROSALYN RICHARDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 HOYT HTS
SUMTER SC
29150-7407
US

IV. Provider business mailing address

81 HOYT HTS
SUMTER SC
29150-7407
US

V. Phone/Fax

Practice location:
  • Phone: 803-236-7363
  • Fax:
Mailing address:
  • Phone: 803-236-7363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberADC-2405
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number10883
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: