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Organization

LIFESPAN NEURODEVELOPMENTAL CONSULTANTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MATTHEW PAUL RICHMOND PSY.D. (LICENSED CLINICAL PSYCHOLOGIST)
(847) 421-0122
Entity
Organization

Contact information

Practice address
33 N DEARBORN ST, SUITE #1600, CHICAGO, IL 60602-3102
(847) 421-0122
(312) 781-6706
Mailing address
33 N DEARBORN ST, SUITE #1600, CHICAGO, IL 60602-3102
(847) 421-0122
(312) 781-6706

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071008839
IL
103TB0200X
Cognitive & Behavioral Psychologist
071008839
IL
103TC0700X
Clinical Psychologist
071008839
IL
103TC2200X
Clinical Child & Adolescent Psychologist
071008839
IL
103TF0000X
Family Psychologist
071008839
IL
103TH0004X
Health Psychologist
071008839
IL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
071008839
IL
103TR0400X
Rehabilitation Psychologist
071008839
IL

Other

Enumeration date
06/20/2014
Last updated
06/20/2014
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