MEDICARE: DR. ELIZABETH RICHARDS PSY.D.

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	103TC0700X	Clinical Psychologist	35SI00655100	NJ
2	103TC0700X	Clinical Psychologist	019656	NY

General Provider Information

NPI Number	:	1518211549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH RICHARDS PSY.D.

Provider Business Mailing Address
First Line	:	3343 PEACHTREE RD NE STE 145-1742
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-1085
Country	:	US
Telephone Number	:	347-470-0127
Fax Number	:

Provider Business Practice Location Address
First Line	:	3343 PEACHTREE RD NE STE 145-1742
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30326-1085
Country	:	US
Telephone Number	:	347-470-0127
Fax Number	:

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

Provider Enumeration Date	:	10/29/2012
Last Update Date	:	01/31/2024

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