MEDICARE: MS. JHONEL RICHARDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC05894200	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043765795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JHONEL RICHARDS

Provider Business Mailing Address
First Line	:	3010 BORDENTOWN AVE
Second Line	:
City	:	PARLIN
State	:	NJ
Zip	:	08859-1181
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3010 BORDENTOWN AVE
Second Line	:
City	:	PARLIN
State	:	NJ
Zip	:	08859-1181
Country	:	US
Telephone Number	:	732-630-9473
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2016
Last Update Date	:	04/12/2021

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