MEDICARE: MS. RITA RENAE RICHARDS LCSW

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	C003943	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	130T7	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184679219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. RITA RENAE RICHARDS LCSW

Provider Business Mailing Address
First Line	:	1330 5TH ST NE
Second Line	:	#135
City	:	HICKORY
State	:	NC
Zip	:	28601-2044
Country	:	US
Telephone Number	:	704-538-0958
Fax Number	:	704-538-3944

Provider Business Practice Location Address
First Line	:	215 SHADY GROVE RD
Second Line	:
City	:	LAWNDALE
State	:	NC
Zip	:	28090-8254
Country	:	US
Telephone Number	:	704-538-0958
Fax Number	:	704-538-3944

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	07/08/2007

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