Individual
MR. GARY ALAN RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACSW MSW LSW
Contact information
Practice address
3210 EUCLID AVE, CLEVELAND, OH 44115
(216) 621-0766
(216) 622-7788
Mailing address
874 GREYTON RD, CLEVELAND HTS, OH 44112
(216) 851-7033
(216) 851-1329
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S0030187
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S0030187
SOCIAL WORK BOARD
OH
Enumeration date
09/29/2006
Last updated
07/08/2007
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