Individual
BEVERLY RICHARD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
19 GREENRIDGE AVE, ANDRUS CHILDREN'S CENTER MENTAL HEALTH DIVISION, WHITE PLAINS, NY 10605-1201
(914) 949-7680
(914) 997-7942
Mailing address
1156 N BROADWAY, ANDRUS CHILDREN'S CENTER, YONKERS, NY 10701-1108
(914) 965-3700
(914) 965-3883
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
010243
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355940
—
NY
01
—
010243
NYS PHD LICENSE #
NY
01
—
1285628552
JDAM NPI #
NY
Enumeration date
05/13/2006
Last updated
07/09/2007
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