| Doctor Name: | JEFFREY D RICHARDSON |
| NPI Number: | 1386988293 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CSAC |
| License Number: | 15702-132 |
| Business Practice Address: | 757 S Main St Suite 8 Fond Du Lac, WI - 549355739 |
| Business Phone Number: | 9207319798 |
| Business Fax Number: | 9207311097 |
| Mailing Address: | W175n11120 Stonewood Dr, GERMANTOWN |
| State: | WI |
| Postal Code: | 530226511 |
| Phone Number: | 2623455560 |
| Fax Number: | 2623455531 |
| NPI Enumeration Date: | 11/15/2012 |
| NPI Last Update Date: | 11/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 15702-132 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |