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General NPI Number Information
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NPI Number | 1578613212
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Entity Type | Individual
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Provider Name | JANE D RICHARD M.A., L.P.C.C.
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 2680 W MARKET ST
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City | FAIRLAWN
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State | OH
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Zip | 44333-4215
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Country | US
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Telephone | 234-867-5001
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Fax | 234-867-5002
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Provider Business Mailing Address
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Address Line | 4335 COPLEY RD
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City | COPLEY
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State | OH
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Zip | 44321-1809
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Country | US
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Telephone | 330-620-4296
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.0501051
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C0501051
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License Number State | OH
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