MEDICARE: MS. ALAYNE ESTELLE RICHARDSON 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	086205	NY

General Provider Information

NPI Number	:	1891042313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALAYNE ESTELLE RICHARDSON LCSW

Provider Business Mailing Address
First Line	:	442 5TH AVE # 1351
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10018-2794
Country	:	US
Telephone Number	:	917-905-9466
Fax Number	:	917-900-1678

Provider Business Practice Location Address
First Line	:	99 WALL ST # 954
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10005-4301
Country	:	US
Telephone Number	:	646-933-5958
Fax Number	:	646-933-5959

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

Provider Enumeration Date	:	08/14/2012
Last Update Date	:	12/28/2021

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