MEDICARE: JOANNE 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	078622-1	NY

General Provider Information

NPI Number	:	1275693988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNE RICHARDS LCSW

Provider Business Mailing Address
First Line	:	16010 E TUMBLEWEED DR
Second Line	:
City	:	FOUNTAIN HILLS
State	:	AZ
Zip	:	85268-3656
Country	:	US
Telephone Number	:	631-827-9784
Fax Number	:

Provider Business Practice Location Address
First Line	:	16010 E TUMBLEWEED DR
Second Line	:
City	:	FOUNTAIN HILLS
State	:	AZ
Zip	:	85268-3656
Country	:	US
Telephone Number	:	631-827-9784
Fax Number	:

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	09/17/2013

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