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General NPI Number Information
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NPI Number | 1730765884
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Entity Type | Organization
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Legal Business Name | RICHARDSON MARTIN INCORPORATED
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 727 W HARGETT ST STE 103
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City | RALEIGH
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State | NC
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Zip | 27603-1669
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Country | US
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Telephone | 919-803-8038
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Fax |
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Provider Business Mailing Address
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Address Line | 727 W HARGETT ST STE 103
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City | RALEIGH
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State | NC
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Zip | 27603-1669
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Country | US
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Telephone | 919-803-8038
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Fax | 919-882-8875
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Authorized Official
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Title or Position | CO-CEO
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Name | MR. LEVI CHRISTOPHER RICHARDSON
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Credential |
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Telephone | 843-409-0491
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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