# CLYDE A RICHARDSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1275709826
- **Gender:** Man
- **Credential:** M DIV CAC-R

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 6802067415 | MI | Yes |
| 101YM0800X | Mental Health Counselor | 6802067415 | MI | — |
| 101YP1600X | Pastoral Counselor | 6802067415 | MI | — |

## Other

- **Enumeration date:** 05/05/2008
- **Last updated:** 06/26/2009