| Doctor Name: | ILENE ANN RICHARDSON |
| NPI Number: | 1427044296 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | LC1278 |
| Business Practice Address: | 15262 Russell Dr Onancock, VA - 234173004 |
| Business Phone Number: | 4107130709 |
| Business Fax Number: | 4105460264 |
| Mailing Address: | 15262 Russell Dr, ONANCOCK |
| State: | VA |
| Postal Code: | 234173004 |
| Phone Number: | 4107130709 |
| Fax Number: | 4105460264 |
| NPI Enumeration Date: | 09/27/2005 |
| NPI Last Update Date: | 01/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LC1278 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |