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General NPI Number Information
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NPI Number | 1578952271
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Entity Type | Individual
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Provider Name | O'NEIL RICHARDS
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Gender | Male
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Dates
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Enumeration Date | 01/19/2015
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Last Update Date | 10/24/2020
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Provider Practice Location Address
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Address Line | 8530 AVEBURY CT
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City | JACKSONVILLE
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State | FL
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Zip | 32244-5983
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Country | US
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Telephone | 718-916-5421
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Fax |
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Provider Business Mailing Address
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Address Line | 8420 COUNTRY BEND CIR E
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City | JACKSONVILLE
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State | FL
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Zip | 32244-7416
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 082779
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12812
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License Number State | FL
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