PHYLLIS J. RICHARDSON CAC-AD NPI 1730244898

NPI Information

NPI: 1730244898
Provider Name: PHYLLIS J. RICHARDSON, CAC-AD
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
2336 GODDARD PKWY
EASTERN SHORE PSYCHOLOGICAL SERVICES
SALISBURY, MD
ZIP 21801
Phone: (410) 334-6961
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Phyllis J. Richardson, CAC-AD is an addiction (substance use disorder) counselor in Salisbury, MD. Phyllis J. Richardson, CAC-AD NPI is 1730244898. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2336 GODDARD PKWY
EASTERN SHORE PSYCHOLOGICAL SERVICES
SALISBURY, MD
ZIP 21801-126
Phone: (410) 334-6961
Fax: (410) 334-6362

The enumeration date for this NPI number is 12/27/2006 and was last updated on 8/30/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	ACO251	MARYLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	1093074064	MEDICAID	MARYLAND
2	705371101	MEDICAID	MARYLAND
3	S013	MEDICARE ID-TYPE UNSPECIFIED	MARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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