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General NPI Number Information
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NPI Number | 1780470245
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Entity Type | Individual
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Provider Name | ISIAH RICHARDSON LPC
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Gender | Male
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Dates
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Enumeration Date | 04/19/2025
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Last Update Date | 04/19/2025
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Provider Practice Location Address
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Address Line | 4000 FABER PLACE DR STE 300
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City | CHARLESTON
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State | SC
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Zip | 29405-8587
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Country | US
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Telephone | 646-941-7645
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Fax | 929-596-7897
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Provider Business Mailing Address
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Address Line | PO BOX 675480
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City | DETROIT
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State | MI
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Zip | 48267-5480
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Country | US
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Telephone | 646-453-6777
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Fax | 929-596-7897
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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 | 9883
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License Number State | SC
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