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General NPI Number Information
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NPI Number | 1255054524
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Entity Type | Individual
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Provider Name | JEFFREY D RICHARDSON
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Gender | Male
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Dates
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Enumeration Date | 09/22/2022
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 1010 WISCONSIN AVE NW STE 340
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City | WASHINGTON
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State | DC
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Zip | 20007-3680
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Country | US
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Telephone | 855-284-7483
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Fax | 617-807-0958
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Provider Business Mailing Address
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Address Line | PO BOX 748465
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City | ATLANTA
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State | GA
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Zip | 30374-8465
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Country | US
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Telephone | 855-284-7483
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Fax | 617-807-0958
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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