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Individual

DR. SAMUEL RICHARDSON III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DCC, LCPC, CTC

Contact information

Practice address
92 CHESTNUT ST, CHERAW, SC 29520-3414
(843) 337-1979
(843) 537-1479
Mailing address
9 CHURCH ST, CHERAW, SC 29520-2707
(843) 337-1979
(843) 537-1479

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
15461
DE
101YM0800X
Mental Health Counselor
15461
FL
101YP1600X
Pastoral Counselor
15461
DE
101YP1600X
Pastoral Counselor
15461
FL
103K00000X
Behavior Analyst
Primary
15461
FL
106H00000X
Marriage & Family Therapist
15461
FL

Other

Enumeration date
10/31/2012
Last updated
10/12/2021
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