MEDICARE: DR. RONALD J RICHARDS PHD

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	1483	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7022689	OTHER	OH	AETNA
2	248274000	OTHER		MAGELLAN
3	000000389835	OTHER	OH	BC

General Provider Information

NPI Number	:	1528117918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD J RICHARDS PHD

Provider Business Mailing Address
First Line	:	5204 MAHONING AVE
Second Line	:	SUITE 105
City	:	AUSTINTOWN
State	:	OH
Zip	:	44515
Country	:	US
Telephone Number	:	330-797-0036
Fax Number	:	330-797-0034

Provider Business Practice Location Address
First Line	:	5212 MAHONING AVE
Second Line	:	SUITE 305
City	:	AUSTINTOWN
State	:	OH
Zip	:	44515
Country	:	US
Telephone Number	:	330-797-8800
Fax Number	:	330-797-8808

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	12/07/2025

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