MEDICARE: TERI J RICHARDS

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	0111721	NM
2	101YP2500X	Professional Counselor	CCMH0159331	NM

General Provider Information

NPI Number	:	1548565187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERI J RICHARDS

Provider Business Mailing Address
First Line	:	518 OLD SANTA FE TRL # 603
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-0398
Country	:	US
Telephone Number	:	505-490-0167
Fax Number	:

Provider Business Practice Location Address
First Line	:	518 OLD SANTA FE TRL # 603
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-0398
Country	:	US
Telephone Number	:	505-490-0167
Fax Number	:

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

Provider Enumeration Date	:	01/12/2011
Last Update Date	:	02/03/2026

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Directions to “ TERI J RICHARDS ” Practice Location

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