MEDICARE: JOHN ANTHONY RICHARDSON LMHC

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	101YM0800X	Mental Health Counselor	39004128A	IN

General Provider Information

NPI Number	:	1225678832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN ANTHONY RICHARDSON LMHC

Provider Business Mailing Address
First Line	:	2225 SOUTH ST
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-7336
Country	:	US
Telephone Number	:	812-214-4422
Fax Number	:

Provider Business Practice Location Address
First Line	:	2990 N STATE HIGHWAY 7
Second Line	:
City	:	NORTH VERNON
State	:	IN
Zip	:	47265-7189
Country	:	US
Telephone Number	:	812-346-7744
Fax Number	:	812-346-3815

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

Provider Enumeration Date	:	01/11/2020
Last Update Date	:	12/09/2023

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