Organization Name: | RICHARDSON COUNSELING CENTER |
NPI Number: | 1306071261 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHARISA R. RICHARDSON (CLINICAL DIRECTOR / OWNER) |
Mailing Address: | 5909 S Adams St Bartonville |
State: | IL US |
Postal Code: | 616071983 |
Phone Number: | 3096331030 |
Fax Number: | 3096331051 |
NPI Enumeration Date: | 05/21/2009 |
NPI Last Update Date: | 05/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | A-6276-0001-A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |