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General NPI Number Information
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NPI Number | 1740914365
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Entity Type | Individual
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Provider Name | MALACHI AMON RICHARDSON PH.D.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 400 7TH ST NW STE 500
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City | WASHINGTON
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State | DC
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Zip | 20004-2324
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Country | US
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Telephone | 305-801-8970
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Fax | 877-809-0772
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Provider Business Mailing Address
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Address Line | 1212 4TH ST SE APT 831
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City | WASHINGTON
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State | DC
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Zip | 20003-3637
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Country | US
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Telephone | 305-801-8970
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 07067
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810007862
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY200001366
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License Number State | DC
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